Postural Function Research Articles

A Randomized and Controlled Crossover Study Investigating the Improvement of Walking and Posture Functions in Chronic Stroke Patients Using HAL Exoskeleton - The HALESTRO Study (HAL-Exoskeleton STROke Study).

Background: The exoskeleton HAL (hybrid assistive limb) has proven to improve walking functions in spinal cord injury and chronic stroke patients when using it for body-weight supported treadmill training (BWSTT). Compared with other robotic devices, it offers the possibility to initiate movements actively. Previous studies on stroke patients did not compare HAL-BWSTT with conventional physiotherapy (CPT). Therefore, we performed a crossover clinical trial comparing CPT and HAL-BWSTT in chronic stroke patients with hemiparesis, the HALESTRO study. Our hypothesis was that HAL-training would have greater effects on walking and posture functions compared to a mixed-approach CPT.Methods: A total of 18 chronic stroke patients participated in this study. Treatment consisted of 30 CPT sessions and of 30 sessions of BWSTT with a double leg type HAL exoskeleton successively in a randomized, crossover study design. Primary outcome parameters were walking time and speed in 10-meter walk test (10MWT), time in timed-up-and-go test (TUG) and distance in 6-min walk test (6MWT). Secondary outcome parameters were the functional ambulatory categories (FAC) and the Berg-Balance Scale (BBS). Data were assessed at baseline, at crossover and at the end of the study, all without using and wearing HAL.Results: Our study demonstrate neither a significant difference in walking parameters nor in functional and balance parameters. When HAL-BWSTT was applied to naïve patients, it led to an improvement in walking parameters and in balance abilities. Pooling all data, we could show a significant effect in 10MWT, 6MWT, FAC and BBS, both therapies sequentially applied over 12 weeks. Thereby, FAC improve from dependent to independent category (3 to 4). One patient dropped out of the study due to intensive fatigue after each training session.Conclusion: HAL-BWSTT and mixed-approach CPT were effective therapies in chronic stroke patients. However, compared with CPT, HAL training with 30 sessions over 6 weeks was not more effective. The combination of both therapies led to an improvement of walking and balance functions. Robotic rehabilitation of walking disorders alone still lacks the proof of superiority in chronic stroke. Robotic treatment therapies and classical CPT rehabilitation concepts should be applied in an individualized therapy program.

Postural Changes After Abdominoplasty in Morbid Obese Patients.

In the multidisciplinary treatment of obesity, the role of a plastic surgeon is to remove the excess of skin after weight loss to obtain cosmetic, functional, and psychological benefits. Obesity modifies body geometry, increases the mass of different segments, and imposes functional limitations in life activities that may predispose the obese to injury. The authors evaluated the postural conditions of obese patients, before and 12 months after surgery. The study included 15 obese patients of both genders affected by class II obesity. Postural function was evaluated preoperatively and 12 months postoperatively. Patients underwent conventional abdominoplasty surgical procedure. In all patients, plantar pressure distribution and balance (stabilometric test) were evaluated before and 3 months after surgery. The static pedobarographic revealed a significant reduction in forefoot peak pressure; total plantar force; rearfoot plantar force percentage; midfoot plantar force percentage; and forefoot, midfoot, and rearfoot plantar contact areas percentage 3 months after surgery; the dynamic's one showed a reduction in the first metatarsal peak pressure and plantar contact. The stabilometric values showed a reduction in the range of center of foot pressure (CP) displacement along y axis, the average displacement of the CP speed from the mean (RMS y velocity), and CP mean peak in the condition of vision. Our study demonstrates the beneficial effect of dermolipectomies and the consequential weight loss on postural stability of obese men. Such findings may support the hypothesis that dermolipectomy may improve postural stability with and without vision. The data demonstrate that the benefits are related to the magnitude of the resected tissue.

Relations between Posture and Trunk Muscle Functions in Girls with Idiopathic Scoliosis

Background. Idiopathic scoliosis (IS) affects 1–3% of children aged 10–16 years (Weinstein et al., 2008). It is important to make comprehensive evaluation and treatment of IS because it provokes health problems and progresses (Negrini et al., 2006). There is a lack of research on muscle impairments, their relations with posture in IS (Parent, Ritchter, 2016). Aim – to assess relations between posture and trunk muscle functions in schoolaged girls with IS. Methods. The study included 20 patients with IS. Anthropometric measurements, measurements of posture (habitual standing posture, posture performing auto-correction and performing Matthias test), functional trunk stability evaluation, trunk muscle static endurance tests were used. Results. After performing auto-correction, thoracic kyphosis signifcantly decreased. Measurements showed decreased static trunk muscle endurance, normal proportions between trunk muscle groups: 75% of subjects have trunk instability. Trunk inclination, left major surface rotation statistically signifcantly changed in functional trunk stability test. Statistical moderate correlations were determined between both side trunk muscle static endurance and: medium surface rotation, major left surface rotation, medium lateral deviation. Also between Cobb angle and static endurance of left side trunk muscles. Changes of major left surface rotation in functional trunk stability test correlated with static endurance ratio of both sides trunk muscles. Statistical strong correlation was determined between major right lateral deviation and both sides muscles static endurance. Conclusions. School-aged girls with IS change kyphosis after auto-correction have low static endurance of trunk muscles and dysfunction of functional stability. Statistically moderate and strong correlations between posture parameters and trunk muscle functions were assessed.Keywords: posture, trunk muscle functions, idiopathic scoliosis, school-aged girls.

Multi-sensory training and wrist fractures: a randomized, controlled trial

BackgroundAsymmetric vestibular function, decreased plantar sensation, postural control and functional ability have been associated with fall-related wrist fractures.ObjectiveTo investigate whether multi-sensory training (MST) improves postural control, vestibular function, foot sensation and functional ability among people with fall-related wrist fractures compared to wrist stabilization training (WT).MethodsThis was an assessor-blinded, randomized controlled trial. Ninety-eight participants, age 50–75 years, were randomized to MST or WT. Pre- and post-training measurements: Head Shake Test (HST), Video-Head Impulse Test (vHIT), Semmes–Weinstein Monofilaments (SWF), Biothesiometer (BT), Sensory Organization Test (SOT), 10-m Walk Test (10MWT), Five Times Sit to Stand Test (FTSTS), Activities-Specific Balance Confidence (ABC) and Dizziness Handicap Inventory Scales (DHI). The training period was 12 weeks, with six supervised sessions by a physical therapist and daily home exercises for both groups.ResultsThere were significant endpoint differences in SOT (p = 0.01) between the two groups, in favor of the MST group, but no changes were seen in other outcome variables. Subgroup analysis with participants below normal baseline SOT composite scores indicated that the MST was more effective in improving 10MWT fast (p = 0.04), FTSTS (p = 0.04), SWF (p = 0.04) and SOT scores (p = 0.04) than the WT.ConclusionsMST improves postural control among people with a fall-related wrist fracture. The results further suggest that the program is more effective for those with SOT balance scores below age-related norms.

Relation between cognitive and cerebello-thalamo-cortical functions in healthy elderly people: Evidence from the Yakumo Study

Relations between cognitive and cerebello-thalamo-cortical functions in healthy elderly people (65–75 years old) were examined by longitudinal behavioral data. Based on the individually calculated cognitive decline ratio in D-CAT (digit cancelation test) and in LMT (Logical Memory Test) during the period of 11 years, participants were classified into the Decline and the Maintain groups and group differences in the postural tremor measures (Quotient of Romberg) were compared. Significant group differences were shown in the postural tremor measure in D-CAT that reflects prefrontal function, but it was not the case in LMT. These results strengthened our previous findings that suggest a strong relation between the cerebello-thalamo-cortical function and the prefrontal cortex function using behavioral measures. Findings provide evidence that to strengthen postural function such as physical exercise is effective for slowing cognitive decline with age.

Substantiation of a procedure for correction of the properties of human motor abilities via biofeedback for support reaction

Stability training, including rehabilitation, using the principle of biofeedback for support reaction on the stabilometric platform, is used to restore the functions of maintaining balance in medicine and to increase vertical stability in athletes, etc. in sports. To substantiate a procedure to correct the properties of human motor abilities during stability training, which are based on the consideration of the consistently involved levels of the nervous system in the construction of movements during games using biofeedback for support reaction. The multilevel motion construction concept proposed by N.A. Bernstein (1947) was analyzed. Computer-assisted stabilometry, including Romberg's test with the eyes open and closed in the European standing (for 51 sec), was used for objective instrumental assessment of postural function. The study included 7 university students who belonged to a special medical group for their health status. The training was stopped when the student felt worse, tired, and unwilling to continue the game. The training duration was 12 to 22 minutes. To obtain reliable results, all stabilometric examinations were made from 8 to 9 o'clock in the morning. The study results were statistically analyzed using the goodness-of-fit test: Z-test (equality of the observed frequencies of two events), Wilcoxon signed rank test (when comparing dependent samples). The paper describes a relationship between the provisions of the multilevel motion construction concept proposed by N.A. Bernstein and the information about the levelled organization of movements during games via biofeedback for support reaction; guidelines for their use and experimental confirmation for the higher function of motor abilities: muscle synergy and kinesthetic sensitivity. There is evidence for the positive training effect on the function of motor ability properties of the pallidothalamic level of the nervous system during games via biological feedback for support reaction, their informative value compared with other stabilometric indicators.

Chordome géant du sacrum et reconstruction par lambeau perforant glutéal supérieur, à propos d’un cas clinique et revue de la littérature

Sacral chordomas are rare primary bone tumors and represent more than half of all primary malignant sacral tumors. Surgical resection is the only treatment with close to 50% of remission at 10 years, with or without radiotherapy. This tissue removal can be very extensive and morbid, particularly for evolved tumors. The reconstruction mostly uses myocutaneous flaps, notably the gluteus maximus flap and the latissimus dorsi flap, increasing morbidity of the surgical procedure. To avoid a muscular sacrifice and reduce the post-surgical morbidity, we describe the case of a patient who underwent a giant sacral chordoma resection and a reconstruction with a superior gluteal artery perforator flap. A 57-y.o. patient with a voluminous sacral chordoma had undergone a partial sacrectomy and abdomino-perineal resection. Firstly, a laparoscopy was realized to create a colostomy, to dissect an omental flap and to prepare the monobloc resection. In a prone position, the resection of the tumor was achieved and a de-epithelialized superior gluteal artery perforator flap was performed to fill the space and to support pelvic organs. For resections of sacral chordomas, coelioscopy has considerably reduced the surgical morbidity. However, the majority of reconstructions use myocutaneous flaps, specifically gluteus maximus and latissimus dorsi, which their postural function is considerable. Muscular sacrifice can lead to functional impotence with difficulty walking and standing up and run contrary to the diminution morbidity initiated by oncologic surgeons.

Experimental Pain Decreases Corticomuscular Coherence in a Force- But Not a Position-Control Task

Differences in neural drive could explain variation in adaptation to acute pain between postural and voluntary motor actions. We investigated whether cortical contributions, quantified by corticomuscular coherence, are affected differently by acute experimental pain in more posturally focused position-control tasks and voluntary focused force-control tasks. Seventeen participants performed position- and force-control contractions with matched loads (10% maximum voluntary contraction) before and during pain (injection of hypertonic saline into the infrapatellar fat pad of the knee). Surface electromyography (EMG) of right knee extensor and flexor muscles was recorded. Electroencephalography (EEG) was recorded using a 128-channel sensor net. Corticomuscular coherence was calculated between 4 EEG electrodes that approximated the contralateral motor cortical area, and EMG. Coherence, EEG, EMG, and target performance accuracy were compared between task types and pain states. Before pain, coherence EEG and EMG did not differ between tasks. During pain, EMG increased in both tasks, but the force-control task showed greater pain interference (decreased coherence, higher EEG frequencies, and increased force fluctuations). Neural substrates of motor performance of postural functions are changed uniquely by experimental pain, which might be explained by differences in cortical demands. Our results provide new insights into the mechanisms of motor adaptations during acute pain. PerspectiveUnderstanding of the mechanisms underlying adaptations to motor function in acute pain is incomplete. Experimental work almost exclusively focuses on voluntary motor actions, but these adaptations may be inappropriate for postural actions. Our results show less pain-related interference in brain activity and its relationship to muscle activation during position-control tasks.

The Effects of Gender, and Functional and Cognitive Training on Postural Control in Middle-Aged People

Introduction: Postural control changes with ageing, and it is essential to study aging-related mechanisms. The aim of this research was to investigate the effects of gender, and functional and cognitive training on balance control in middle-aged people. Materials and Methods: This was a practical study with subimpirical method. The participants were 80 middle-aged people (40 men and 40 women), who were selected according to inclusion criteria, and randomly assigned to eight groups of internal and external focus guidelines in cognitive and functional supra-postural tasks. The postural status was evaluated by measuring the alignment of centre of gravity (COG) through a master balancing system using modified clinical test of sensory interaction and balance (mCTSIB). Results: Based on one-way analysis of variance, men and women who took the focal point of external attention in both functional and cognitive tasks had better postural control (P = 0.002). Men with external focus in functional task had better postural control than the other groups, and Women with internal focus in cognitive tasks had the weakest postural control function. Totally, men in functional and cognitive tasks had a better postural control function than women (P = 0.002). Conclusion: Adopting functional supra-postural strategy is better than cognitive supra-postural strategy in both middle-aged men and women in order to maintain balance. Regarding the fact that women with cognitive tasks with internal focus showed a significant difference in postural control than other groups, it is advisable to focus on stress management methods under stressful conditions for instructors. It seems that these findings are useful for mentors and therapists to design equilibrium exercises by considering age, gender, and type of attention instruction to avoid falling and performing dual tasks.

Оценка нарушений постуральной функции позвоночника в ортостатических стереотипах

There is no unified system for assessing the functional mobility (lability) of the spine to diagnose its hypermobility, pathological mobility and instability. In the absence of such a system, biomechanical characteristics of spinal segments, revealed in normal individuals and by clinical examination of patients, are instrumentally and metrically incommensurable with its kinematic characteristics detected in functional radiographs. Purpose Development of criteria and methods to assess the postural function (lability) of the spine and the rigidity of its deformations for their consideration and suggestion as a metric standard Materials and methods Patients (n = 43) aged 9 to 23 years with clinical and radiological signs of spinal curvatures of grades 2 to 4 (according to Chaklin) and orthopedically healthy subjects of the same age (n = 79) were examined. Instrumental analysis of the monitored postural activity of the trunk and spine in orthostatics was carried out by the optoelectronic method KOMOT. Results and discussion It was established that the postural characteristics of spinal deformities are significantly different in sample populations in terms of expected magnitude of curvature and variability. If in postural and in sample sets the angular characteristics of spinal curves obey the law of normal distribution, then their postural variation in samples tends to a power-law type of distribution. In orthostatic position, the power-law type of the variability distribution was reliably manifested not only with respect to the angular characteristics of spinal curvatures, but also with respect to the variability of a number of other postural parameters. As a result of the analysis of the distribution of random variables characterizing the angular curves of the spine in orthostatic stereotypes and the dependencies between their variation and the expected values in sample populations, a quantitative topographic evaluation of the functional mobility of the spine according to the index of postural lability (IPL) was proposed. Conclusion To adequately assess the postural function of the spine (its lability), it is necessary to have not only a single-stance recording of the parameters under study but to repeatedly register them in a feasible prolonged examination. Only mathematically expected values and root-mean-square deviations of angular parameters reflect more fully the state of spinal curvatures and have the necessary and sufficient diagnostic information. A quantitative topographic estimation of the functional mobility of the spine according to index of postural lability (IPL) is suggested. Normally, IPL is in the range of 30 to 75 %. If the index is less than 30 %, the spine is hypermobile; if it is more than 75 %, the spinal column is rigid.

The Treatment of Autism Spectrum Disorder With Auditory Neurofeedback: A Randomized Placebo Controlled Trial Using the Mente Autism Device.

Introduction: Children affected by autism spectrum disorder (ASD) often have impairment of social interaction and demonstrate difficulty with emotional communication, display of posture and facial expression, with recognized relationships between postural control mechanisms and cognitive functions. Beside standard biomedical interventions and psychopharmacological treatments, there is increasing interest in the use of alternative non-invasive treatments such as neurofeedback (NFB) that could potentially modulate brain activity resulting in behavioral modification.Methods: Eighty-three ASD subjects were randomized to an Active group receiving NFB using the Mente device and a Control group using a Sham device. Both groups used the device each morning for 45 minutes over a 12 week home based trial without any other clinical interventions. Pre and Post standard ASD questionnaires, qEEG and posturography were used to measure the effectiveness of the treatment.Results: Thirty-four subjects (17 Active and 17 Control) completed the study. Statistically and substantively significant changes were found in several outcome measures for subjects that received the treatment. Similar changes were not detected in the Control group.Conclusions: Our results show that a short 12 week course of NFB using the Mente Autism device can lead to significant changes in brain activity (qEEG), sensorimotor behavior (posturography), and behavior (standardized questionnaires) in ASD children.

발목관절의 키네지오 테이핑 적용이 대학생들의 운동 수행 시 자세조절기능에 미치는 영향

발목관절의 키네지오 테이핑 적용이 대학생들의 운동 수행 시 자세조절기능에 미치는 영향

Betahistine Treatment in a Cat Model of Vestibular Pathology: Pharmacokinetic and Pharmacodynamic Approaches.

This study is a pharmacokinetic (PK) and pharmacodynamics (PD) approach using betahistine doses levels in unilateral vestibular neurectomized cats (UVN) comparable to those used in humans for treating patients with Menière's disease. The aim is to investigate for the first time oral betahistine administration (0.2 and 2 mg/kg/day) with plasma concentrations of betahistine and its major metabolite 2-pyridylacetic acid (2-PAA) (N = 9 cats), the time course of posture recovery (N = 13 cats), and the regulation of the enzyme synthesizing histamine (histidine decarboxylase: HDC) in the tuberomammillary nuclei (TMN) of UVN treated animals (N = the same 13 cats plus 4 negative control cats). In addition the effect of co-administration of the lower betahistine dose (0.2 mg/kg/day) and selegiline (1 mg/kg/day), an inhibitor of the monamine oxidase B (MAOBi) implicated in betahistine catabolism was investigated. The PK parameters were the peak concentration (Cmax), the time when the maximum concentration is reached (Tmax) for both betahistine and 2-PAA and the area under the curve (AUC). The PD approach consisted at quantifying the surface support area, which is a good estimation of posture recovery. The plasma concentration-time-profiles of betahistine and 2-PAA in cats were characterized by early Cmax-values followed by a phase of rapid decrease of plasma concentrations and a final long lasting low level of plasma concentrations. Co administration of selegiline and betahistine increased values of Cmax and AUC up to 146- and 180-fold, respectively. The lowest dose of betahistine (0.2 mg/kg) has no effects on postural function recovery but induced an acute symptomatic effect characterized by a fast balance improvement (4–6 days). The higher dose (2 mg/kg) and the co-administration treatment induced both this acute effect plus a significant acceleration of the recovery process. The histaminergic activity of the neurons in the TMN was significantly increased under treatment with the 2 mg/kg betahistine daily dose, but not with the lower dose alone or in combination with selegiline. The results show for the first time that faster balance recovery in UVN treated cats is accompanied with high plasma concentrations of betahistine and 2-PAA, and upregulation of HDC immunopositive neurons in the TMN. The higher betahistine dose gives results similar to those obtained with the lower dose when co-administrated with an inhibitor of betahistine metabolism, selegiline. From a clinical point of view, the study provides new perspectives for Menière's disease treatment, regarding the daily betahistine dose that should be necessary for fast and slow metabolizers.

Virtual reality training system based on lower limb rehabilitation robot

This paper presents a virtual reality training system for the lower limb rehabilitation robot, which can simulate the bike riding and encourage patients to join in the recovery training through the built-in competitive game. The virtual reality training is a variable speed active training under the constraint trajectory, and it has adapting training posture function which can provide individual riding training track according to the legs length of patients. The movement synchronization between the robot and virtual model is achieved by interaction control strategy, and robot can change the training velocity based on the signal from feedback terrains in game. A serious game about bike match in forest was designed, and the user can select the training level as well as change perspective through the user interface. The training can be paused at any time, and the timer function could reflect the recovery of patient.

발목관절의 키네지오 테이핑 적용이 대학생들의 운동 수행 시 자세조절기능에 미치는 영향

발목관절의 키네지오 테이핑 적용이 대학생들의 운동 수행 시 자세조절기능에 미치는 영향

P2-5-09. Effect of transcranial direct current electrical stimulation on supplementary motor cortex on control of balance in healthy subjects

Use of transcranial direct current electrical stimulation (tDCS) in rehabilitation has been reported, but few on the effects of tDCS on posture and balance. Our objective was to clarify the influence of tDCS of the supplementary motor area (SMA) on balance in healthy people. Eight healthy adults (4 males, 4 females, mean age 25 yrs) who gave informed consent were enrolled. For tDCS, the anode was attached by tape to the scalp above the SMA, likewise and the cathode was placed at the external occipital protuberance., and Stimulation at intensity of 1 mA was applied for 20 min. The same procedure without stimulation was followed for sham stimulation. Before and after stimulation subjects performed raising of upper limbs while standing, and maintaining a single leg standing position, on a stabilometer. Items evaluated were shortening of the total trajectory length of the center of gravity movement during and after raising the upper limbs before and after the stimulation, and shortening of the total trajectory length of the center of gravity movement during maintaining the single posture. It is thought that tDCS anodic stimulation of the SMA promoted the posture adjustment function of SMA and contributed to a decrease in center of gravity fluctuation.

Initial Studies of Validity of the Sensory Processing 3-Dimensions Scale

ABSTRACTAims: This study examined the validity of a new measure of sensory processing for children, the Sensory Processing 3-Dimensions Scale (SP-3D). The SP-3D is a performance-based measure for children ages three to thirteen years, designed to assess sensory processing abilities, and identify the three patterns of sensory processing disorder (SPD) and related subtypes, including sensory modulation, sensory discrimination, and sensory-based motor disorders. Methods: Age trends were explored using descriptive statistics and graphing techniques with a sample of children with and without SPD. SP-3D scores were correlated with scores from the Sensory Processing Measure (SPM) to examine criterion-related validity. Discriminant validity was assessed by comparing SP-3D scores from children with and without SPD. Results: Age trends of SP-3D scores supported sensory discrimination, praxis and postural functions as developmental constructs. Several mild to moderate correlations were found between the scores of the SP-3D and the SPM, indicating that the tools are measuring similar constructs, and supporting the SP-3D as a measure of sensory processing. Modulation and Motor Behavior Scores from the SP-3D discriminated typically developing children from those with SPD, while results from subtests measuring sensory discrimination, postural and praxis were mixed regarding capacity for discrimination suggesting revision to several items. Conclusion: The study provides preliminary evidence of the SP-3D as a valid measure of sensory processing abilities and dysfunction. Further research regarding the reliability and validity of the SP-3D are needed.

Role of axial and support unloading in development of hypogravitational motor syndrome

Event Abstract Back to Event Role of axial and support unloading in development of hypogravitational motor syndrome Elena S. Tomilovskaya1*, Ilya V. Rukavishnikov1, Tatiana A. Shigueva1, Tatyana B. Kukoba1, Inna S. Sosnina1, Lyubov E. Amirova1 and Inessa B. Kozlovskaya1 1 Institute of Biomedical Problems (RAS), Russia Dry Immersion (DI) studies that were performed for years at the Institute of Biomedical Problems have shown that support withdrawal is followed by the development of hypogravitational motor syndrome signs (HMS), similar to those observed after space flights: postural muscle atonia and atrophy, hyperreflexia of spinal reflexes, voluntary movement discoordination, postural and locomotor alterations, back pain etc. (Kozlovskaya et al., 1988; 2007; Miller et al., 2004; Shenkman et al., 2017). Daily mechanical stimulation of the soles during DI eliminates the mentioned effects almost to full extent (Grigoriev et al., 2004; Kozlovskaya et al., 2007). Basing on these results it was concluded that support afferentation plays the role of trigger in development of HMS. However it is necessary to take into account that withdrawal of weight in weightlessness and DI is followed not only by supportlessness but also by axial unloading. So the aim of this work was to study the effects of supportlessness coupled with axial loading to define the role of axial load on HMS development. Twenty healthy volunteers divided into 2 groups took part in the study. No influences except 5-days DI was used in the group which served as a control. The subjects of experimental group in DI every day for 4 hours were wearing "Penguin" axial loading suit that provided the 16-18 kg axial load on the body – from the shoulders to the ankles. Parameters of the postural and locomotor activities, the spinal stretch reflexes, the accuracy of voluntary movements, intervertebral discs height, back pain intensity, tone and force-velocity properties of leg and back muscles have been studied. All the mentioned signs of HMS were observed in the control group: the tone of postural muscles sharply decreased, hypereflexia of stretch reflexes was observed, muscle strength and endurance decreased, postural stability was altered, voluntary movement coordination declined. Results of the experiments confirmed our previous suggestion that muscular atonia provides the development of movement disorders, back pain and other phenomena such as increase of height, elongation of the spine and height of intervertebral disks, etc. (Rukavishnikov et al., 2016; Treffel et al., 2016). Back extensor muscles atonia and significant increase in the intervertebral disk height were registered in the lumbar spine projection; at the same localization all test subjects reported the symptoms of back pain. In the experimental group the intensity of back pain was significantly lower (p=0.0028 for DI1, p=0.006 for DI2 and p=0.0004 for DI3 – by ANOVA repeated measures with Bonferroni correction) (Fig.1). Figure 1. Back pain intensity in the course of Dry Immersion in 2 groups. * - significant difference compared to the baseline; @ - significant difference between groups (p<0.01). Height increase and the decline of force-velocity properties of back and neck muscles were also significantly lower than in the group without countermeasures (p<0.05). However for the leg muscles the changes were similar to the control group. Spinal reflex facilitation (Fig.2), accuracy of hand voluntary movements’ decrease and other HMS signs were not significant in this group. Slight tendency to H-reflex threshold decrease was registered in this group, however the changes were not significant (p=0.062). Figure 2. Changes of spinal reflex characteristics in 2 groups in the course of Dry Immesion. A – Changes in the threshold of H-reflex; B – Changes in peak amplitude of H-response. Blue lines – the group of “pure” immersion with no countermeasures; red dotted lines – the group of 4 hours daily axial loading in the course of Dry immersion. * - p<0.05 compared to baseline values; @ - significant difference between group (p<0.05). There were not revealed significant difference between groups in parameters of postural and locomotor coordination. The results of the study have shown that axial unloading in microgravity plays significant role in development of HMS. However it reveals more tight connections of avail loading to muscles of the body when the support reactions are involved to a great extent in the control of leg muscles state and locomotor and postural functions. Figure 1 Figure 2 Acknowledgements The study is supported by RFBR № 16-29-08320-OFI-m.

The prognostic factors of the effectiveness of the stability training in the patients presenting with musculoskeletal system diseases

One of the main syndromes characteristic of the patients suffering from the diseases of the musculoskeletal system is postural instability. Stability training is a functional method for the restoration of postural balance in the patients presenting with the diseases of the musculoskeletal system. The objective of the present study was to determine the predictors of the effectiveness of stability training based on biological feedback in the patients with the diseases of the musculoskeletal system. The study included a total of 128 patients (104 patients in the main group and 24 ones in the control group) with the following nosological forms: spinal spondylarthrosis, coxarthrosis, gonarthrosis. All the patients underwent a course of the standard rehabilitation treatment the basis of which was constituted by physical therapy. The patients of the main group additionally received stability training based on biological feedback for 10 to 20 minutes daily. The prognostic factors of the effectiveness of biological feedback-based stability training in the patients with musculoskeletal system diseases were identified including the age, reactive and personal anxiety indicators using the Spielberger-Hanin anxiety scale, depression indicators based on the Beck depression scale, the indicators of functional independence and daily activity based on the Morse-Fall-Scale scale, visualization data, the results of duplex scanning of brachiocephalic arteries. These factors, in varying degrees, had an impact on the stabilometric parameters used for the purpose of stability training. The results of the study give evidence of the beneficial influence of the stability training based on biological feedback on the recovery of the postural functions in the patients presenting with the diseases of the musculoskeletal system.

Relationship between Muscle Function, Muscle Typology and Postural Performance According to Different Postural Conditions in Young and Older Adults.

Although motor output of the postural function clearly influences postural performance in young and older subjects, no relationship has been formally established between them. However, the relationship between lower-extremity muscle strength/power and postural performance is often pointed out, especially in older subjects. In fact, the influence of motor output may vary according to the postural condition considered (e.g., static, dynamic, challenging, disturbing). In static postural condition, there may be a relationship between lower-extremity muscle strength and postural performance when the value of muscle strength is below a certain threshold in older subjects. Above this threshold of muscle strength, this relationship may disappear. In dynamic postural condition, lower-extremity muscle power could facilitate compensatory postural actions, limiting induced body imbalance likely to generate falls in older subjects. In young subjects, there could be a relationship between very early rapid torque of the leg extensor muscles and postural performance. In the case of postural reaction to (external) perturbations, a high percentage of type II muscle fibers could be associated with the ability to react quickly to postural perturbations in young subjects, while it may enable a reduction in the risk of falls in older subjects. In practice, in older subjects, muscle strength and/or power training contributes to reducing the risk of falls, as well as slowing down the involution of muscle typology regarding type II muscle fibers.