Postural Stability In Athletes Research Articles

Relationship Between Postural Stability and Proprioception, Pain, Quadriceps Strength, and Muscle Tightness in Athletes With Patellar Tendinopathy.

Athletes with patellar tendinopathy (PT) have postural stability deficits; however, the underlying mechanisms and factors responsible remain unknown. The effect on postural stability in PT of decreased quadriceps strength, altered proprioception, lower-limb muscle tightness, and knee pain, which explain postural stability deficiency in other populations, is uninvestigated. Proprioceptive acuity, muscle tightness, quadriceps strength, and pain predict postural stability in athletes with PT. Cross-sectional comparative study. Level 2. A total of 43 athletes with PT and 43 healthy athletes were enrolled. Static and dynamic postural stability, proprioceptive acuity, muscle tightness, quadriceps strength, and pain were evaluated using a force platform, Y-balance test (YBT), a weight discrimination protocol, a goniometer, an isometric dynamometer, and a valid questionnaire, respectively. Athletes with PT had significantly worse static and dynamic postural stability in the affected limb (AL) compared with the nonaffected limb (NAL) (P < 0.01) and the control group (P < 0.01). Athletes suffering from PT revealed lower quadriceps strength (P < 0.01), proprioceptive acuity (P = 0.02), and higher muscle tightness in the AL compared with the NAL and controls. Quadriceps weakness of the AL and pain in athletes with PT explained the variance of dynamic postural stability impairment. Athletes with PT have postural stability deficiency compared with healthy peers. Our results demonstrate that quadriceps muscle weakness and pain are the factors that explain postural stability impairment. These results can assist clinicians in the design of therapeutic balance rehabilitation programs by acting not only on pain relief but also on quadriceps strengthening through resistance training to avoid subsequent injuries in athletes with PT.

Virtual Reality Environment Training Effect on Dynamic and Static Postural Stability among Athletes from Random Intermittent Dynamic Type Sports

This study aims to investigate the aftereffect of a six-week virtual reality environment training on dynamic and static postural stability in athletes participating in random intermittent dynamic type sports. The pretest and posttest study designs were chosen to conduct this study. Twenty-four male athletes were selected for the study. Participants participated in a six-week virtual reality environment training program three times a week for a session of forty-five minutes. The virtual reality environment was created using CAREN's integrated virtual reality system with Motek's D-flow application. The postural stability was assessed using a stadiometer. Assessments were performed before and after six weeks of training. A paired sample t-test was used to determine differences between pretest and posttest outcome measures. The improvement can be seen as an effect of virtual reality environment training intervention. Statistically significant differences were observed between pretest and posttest for dynamic and static anteroposterior and mediolateral postural stability at 20 and 40 levels of difficulty. The virtual reality environment training helps to improve performance by assessing and optimizing the training load in the process of improving the performance of athletes participating in random intermittent dynamic type sports.

Postural stability in athletes: The role of sport direction.

The bulk of relevant studies compare individual or very few sports and on small samples of athletes. This requires extensive analysing postural stability in various sports. The main objective of our study was to identify the features of postural stability in a normal vertical stance in athletes of various kinds. This study compares postural stability in a normal bipedal stance with eyes open (EO) and eyes closed (EC) conditions among athletes (n = 936, age: 6-47 years) from different sports and performance level. Postural stability was measured through the center of pressure (COP) sway area (AS) and velocity (VCP) while standing quietly in a normal bipedal position with EO and EC on a stabiloplatform (50 Hz). The order of VCP-EO increase in athletes compared to Control was as follows: Shooting (-11.3 %, p < .0001) < Football (-10.4 %, p < .0001) < Boxing (-8.7 %, p < .0001) < Cross-Country Skiing (-7.2 %, p < .0001) < Gymnastics (-7.0 %, p < .0001) < Running (-6.9 %, p < .0001) < Team Games Played with Hands (-6.8 %, p < .0001) < Wrestling (-6.3 %, p < .0001) < Tennis (-5.5 %, p = .0004) < Alpine Skiing (-5.4 %, p = .002) < Rowing (-5.0 %, p = .194) < Speed Skating (-4.7 %, p = .004) < Figure Skating (-3.6 %, p = .034) < Control. Practicing any kind of sport was associated with increased postural stability in normal bipedal stance. This is the first study that provides reference values of COP sway and velocity with and without visual control on a stable force platform for different sport groups.

Relationship between Respiratory Muscle Function and Postural Stability in Male Soccer Players: A Case-Control Study.

The important role of postural stability in exercise performance has been determined by several authors. Despite this, few studies have analyzed the relationship between respiratory muscles’ strength and postural stability in athletes. For this reason, the aim of this study was to investigate the relationship between postural stability and respiratory muscles’ function in male soccer players. A case-control study was conducted over twenty-eight healthy men (18 soccer players; 10 non-athletes). Inspiratory muscle strength (MIP) and respiratory resistance (MVV) were obtained through a digital spirometer. Stability variables were obtained in standing position on a stabilometric platform and in open and closed eyes conditions. The area and length of the center of pressures and displacements in the X and Y range were analyzed. Pearson’s coefficient was used to measure the linear correlation between MIP, MVV and stabilometric variables. In the soccer players’ group, MIP and MIP % predictive were inversely correlated with length (r = −0.535 and r = −0.585; p < 0.05) and X range (r = −0.527 and r = −0.560; p < 0.05), whereas MVV was directly correlated with length (r = 0.606; p < 0.01) and Y range (r = 0.558; p < 0.05). Our results show that the greater the inspiratory muscle strength, the less displacement of the pressure center, while at higher respiratory rates there is greater displacement.

Postural Stability in Athletes during Special Hurdle Tests without a Definite Dominant Leg.

The purpose of this study was to analyze the body balance control of people walking and hurdling with or without a specific dominant leg in a monopodal position. This study involved 28 physical education students. The center of pressure (COP) was measured with a force plate under four conditions: single-leg standing (right and left) with eyes open and two upper limb positions (the arms were positioned in either a specific hurdle technique manner or alongside the body). A repeated measures analysis of variance (ANOVA) was conducted separately for five parameters of the COP in the medial-lateral (ML) and anterior-posterior (AP) directions under the four conditions. In the single-leg position, athletes without a dominant lower leg had better body balance than those with a dominant lower leg. The position of the upper limbs influenced the body position when hurdling. Accepting the correct position of the upper limbs helped to maintain balance (when overcoming hurdles). In hurdles, the position of the upper limbs should be improved to maintain postural stability and save this function for more demanding postural tasks.

Динамическая позная устойчивость высококвалифицированных спортсменов, специализирующихся в игровых видах спорта

The production of manifold and rapidly varying movements in team sports requires maintaining an erect posture. This paper aimed to study dynamic postural stability in athletes engaged in team sports. Among the participants were high-level basketball players (n = 15), rugby players (n = 15) and football players (n = 12), as well as 30 young people not professionally involved in sports, all aged 18–21 years. Postural stability was evaluated using stability analyser Stabilan-01 (OKB Ritm, Taganrog). We utilized the Evolventa test, which simulates the real situation of tracking movements in the games, allowing us to quickly assess not only the quality of the athlete’s tracking movement, but also the reserves of maintaining the stability of erect posture. Classical and vector stabilographic characteristics of upright posture stability were analysed. To assess the quality of tracking, special game indicators were used. Athletes demonstrated a significant superiority in the accuracy of performing motor tasks and at the same time in maintaining postural stability over young men not playing sports (p ≤ 0.05). Noteworthy, basketball players had the highest tracking accuracy in the frontal and, especially, in the sagittal plane (p ≤ 0.05). Moreover, basketball players kept their balance much better, surpassing rugby players and, above all, football players in most indicators in both planes (p ≤ 0.05). Thus, the effectiveness, accuracy and speed of completing tasks, as well as fewer errors in high-level athletes were combined with an automated ability, due to the stereotype formed over many years of training, to confidently maintain an upright position even in the most difficult game situations. However, when analysing postural stability, one must take into account the specifics of the sports under study, where a wide variety of ball-handling techniques is combined with competitive activity of the hands or feet.

Postural Stability in Athletes: The Role of Age, Sex, Performance Level, and Athlete Shoe Features.

The effects of different factors—such as age, sex, performance level, and athletic shoe features—on postural balance in athletes remain unclear. The main objective of our study is to identify the features of postural stability in athletes of different age, sex, performance level, and using different types of athletic shoes. This study assessed postural stability in athletes (n = 936, 6–47 years) in a normal bipedal stance with eyes open (EO) and eyes closed (EC). Postural stability was evaluated based on the center of pressure (COP), sway area (AS), and velocity (VCP) while standing on a stabiloplatform. Children (6–12 years) and teen athletes (13–17 years) showed reduced AS-EO (p < 0.01) and VCP-EO (p < 0.01) compared to control (n = 225, 7–30 years). In male and female athletes aged 18+, only VCP-EC was lower versus control. In females (13–17 and 18+), VCP-EO and EC were lower than in males (p < 0.05). Only in the Shooting group, the athletes’ performance levels had an effect on VCP-EO (p = 0.020). Long use of rigid athletic shoes with stiff ankle support was associated with reduced posture stability. Postural stability in athletes was mostly influenced by the athlete‘s age, and, to a lesser extent, by their sex, performance level, and athlete shoe features.

Comparison of core neuromuscular control and lower extremity postural stability in athletes with and without shoulder injuries

BackgroundThe kinetic chain theory is widely used as a rationale for the inclusion of core stability training in athletes. Core stability (muscle capacity and neuromuscular control) impairments may result in less than optimal performance and abnormal force dissipation to the shoulder complex that could lead to shoulder injuries. However, a paucity of literature exists to support this relationship, and no previous studies have investigated the relationship between isolated core neuromuscular control and shoulder injuries. Additionally, lower extremity postural stability has been associated with athletic function and may also be associated with shoulder injuries. The purpose of this study was to compare biomechanical measures of isolated core neuromuscular control and lower extremity postural stability between athletes with and without non-traumatic shoulder injuries. MethodsEighty athletes (55 males, age: 21.2 ± 3.3 years, 40 with a current shoulder injury) completed biomechanical measures of isolated core neuromuscular control and lower extremity postural stability. Athletes were matched by age, gender, body mass index, and sport type. MANOVAs were used to assess differences between measures of core neuromuscular control and lower extremity postural stability between groups. FindingsThere were no statistically significant differences between athletes with and without shoulder injuries for the static core neuromuscular control measures, F(4,75) = 0.45, P = 0.78, η2 = 0.02; dynamic core neuromuscular control measures, F(4,75) = 0.81, P = 0.52, η2 = 0.04; or lower extremity postural stability measures, F(8,61) = 0.85, P = 0.56, η2 = 0.10. InterpretationAlthough core stability is widely incorporated in rehabilitation of athletes with shoulder injuries, athletes with current non-traumatic shoulder injuries may not present with impairments in core neuromuscular control or lower extremity postural stability.

Visual perturbation impacts upright postural stability in athletes with an acute concussion

ABSTRACTObjective: The impact that visual perturbation has on upright postural stability in an athlete with a concussion has not been established. The present study aimed to characterize the influence that visual perturbation stimuli have on upright balance among athletes with acute concussions.Design: A 2X2X2 repeated measure designed was used.Method: The present study examined the influence visual perturbation has on individuals suffering from an acute concussion. Fourteen participants (7 with a concussion and 7 matched controls) underwent various balance assessments with and without visual perturbation.Results: Overall, athletes with acute concussions demonstrated impairments in balance 24–48 hours following a concussion. However, when assessed using a visual perturbation task, athletes with acute concussions demonstrated improved balance, while control subjects did not show any significant changes during the same visual perturbation task.Conclusion: An athlete’s ability to disregard visual perturbation stimuli is imperative for successful participation in sports. Due to the observed alterations in balance when given a visual perturbation task, it is suggested that athletes with acute concussions place more attention on the balance task and may disregard other less meaningful tasks.

Postural stability deficit could predict ankle sprains: a systematic review.

To perform a systematic review aimed to determine (1) if the postural stability deficit represents a risk factor for ankle sprains; (2) the most effective postural stability evaluation to predict ankle sprains and (3) eventual confounding factors that could influence postural stability and ankle sprain risk. A systematic electronic search was performed in MEDLINE, EMBASE and CINAHL using the search terms (balance) OR (postural stability) matched with (lower limb) OR (ankle) OR (foot) and (sprain) OR (injury) on October 2 2017. All prospective studies that evaluated postural stability as risk factor for ankle sprains were included. The PRISMA Checklist guided the reporting and data abstraction. Methodological quality of all included papers was carefully assessed. Fifteen studies were included, evaluating 2860 individuals. Various assessment tools or instruments were used to assess postural stability. The injury incidence ranged from 10 to 34%. Postural stability deficit was recognized as risk factor for ankle sprain (OR = 1.22-10.2) in 9 cases [3 out of 3 with Star Excursion Balance Test (SEBT)]. Among the six studies that measured the center-of-gravity sway, five were able to detect worse postural stability in athletes that sustained an ankle sprain. In nine cases, the measurement of postural stability did not show any statistical relationship with ankle sprains (four out of five with examiner evaluation). In the studies that excluded patients with history of ankle sprain, postural stability was reported to be a significant risk factor in five out of six studies. The ultimate role of postural stability as risk factor for ankle sprains was not defined, due to the high heterogeneity of results, patient's populations, sports and methods of postural stability evaluation. Regarding assessment instruments, measurement of center-of-gravity sway could detect athletes at risk, however, standardized tools and protocols are needed to confirm this finding. The SEBT could be considered a promising tool that needs further investigation in wider samples. History of ankle sprains is an important confounding factor, since it was itself a source of postural stability impairment and a risk factor for ankle sprains. These information could guide clinicians in developing screening programs and design further prospective cohort studies comparing different evaluation tools. I (systematic review of prospective prognostic studies).

Comparison of jump-landing protocols with Biodex Balance System as measures of dynamic postural stability in athletes

The objective of the study was to determine whether a relationship exists between the two common methods for assessing postural stability in athletes: the time-to-stabilisation (TTS) via force-plate and the Biodex Balance System (BBS). The conditions under which these measurements assess dynamic postural control may not provide sufficient feedback to practitioners. Fourty-four amateur soccer players with no history of musculoskeletal disorders volunteered for the study. Pearson correlation was used to compare the anterior–posterior (AP), medio-lateral (ML), and the overall stability indexes measured by BBS, with the corresponding parameters of TTS assessed via force plate. There was no significant correlation between any parameters of dynamic stability measured by force-plate and the stability indexes. However, there was a significant correlation between the resulting vectors and the AP component of TTS for each jump protocol. Furthermore, forward drop landing exhibited shortest TTS in AP direction, while lateral drop landing resulted in longer ML TTS relative to both forward jumps (p < 0.001). These results demonstrate that the TTS and BBS stability indexes should be used as distinct measures of dynamic postural stability. TTS protocols may be modified to target a specific training conditions or athletic population.

Dual-Tasking Effects on Dynamic Postural Stability in Athletes With and Without Anterior Cruciate Ligament Reconstruction.

To compare the effect of dual tasking on postural stability between patients with anterior cruciate ligament reconstruction (ACL-R) and healthy controls. Single-limb postural stability was assessed in 17 athletes with ACL-R and 17 healthy matched athletes while standing on a Biodex Balance System platform in 4 conditions: stability level of 8 (ie, more-stable support surface) with eyes open, stability level of 8 with eyes closed, stability level of 6 (ie, less-stable support surface) with eyes open, and stability level of 6 with eyes closed. Postural-stability tasks were performed with and without auditory Stroop task. The anteroposterior stability index (APSI), mediolateral stability index (MLSI), and overall stability index (OSI) as measures of postural performance, as well as reaction time and error ratio as measures of cognitive performance, were recorded. Dual-tasking effect on postural stability was not significantly different between the groups in 3 postural conditions. Only in level 6 with eyes open, for APSI and OSI, patients with ACL-R showed lower postural stability under the dual-task condition. However, patients showed poorer performance on both reaction time and error ratio in all postural conditions. The patients with ACL-R appeared to sacrifice their cognitive performance to optimize their performance on postural stability. This posture-first strategy was reflected by a more pronounced effect of dual tasking on the auditory Stroop task than the postural-stability task. In situations where maintenance of posture is challenging, giving priority to the postural task at the expense of cognitive performance can ensure safety from balance loss.

Effects of Prefabricated Ankle Orthoses on Postural Stability in Basketball Players with Chronic Ankle Instability

Ankle sprain is one of the most common injuries among athletes and instability and injury to this joint is responsible for long time loss of physical and recreational activity. Also, it can impose high costs to sport teams. Prevention of this injury is an important concern of practice and rehabilitation. One way of reducing the possibility of ankle joint injury is using an ankle orthosis. The present study aimed at inspecting the effects of two ankle orthoses on dynamic and semi-dynamic postural stability in athletes with chronic ankle instability (CAI). Twenty basketball players with CAI and fifteen non-injured athletes volunteered to participate in this study. Biodex Balance System was used to assess the participants' postural stability in bilateral position at level 8 and level 2. Repeated measures analysis of variance (ANOVA) was performed in order to examine the effects of ankle orthoses. Statistical significance level was determined at P< 0.05. Statistical analyses revealed the significant effect of ankle supports on dynamic and semi-dynamic postural stability in the two groups and results indicated there wasn't significant difference between groups. According to our results the orthoses improved both dynamic and semi-dynamic postural stability. Therefore, orthoses can prevent injury and its reoccurrence.

The Role of Age and Sex in Symptoms, Neurocognitive Performance, and Postural Stability in Athletes after Concussion: Covassin T, Elbin RJ, Harris W, et al. Am J Sports Med 2012;40:1303–12.

Recent research on outcomes after concussions has focused on sex and age differences, specifically, younger athletes and female athletes may take longer to recover. Covassin et al. further explore the interactive effects of age and sex on specifically reported symptoms, neurocognitive testing, and postural stability after concussive injury.

The Role of Age and Sex in Symptoms, Neurocognitive Performance, and Postural Stability in Athletes After Concussion

Background: Researchers have begun to focus on age and sex differences in concussion outcomes. Results suggest that younger athletes and female athletes may take longer to recover from a concussion. However, little is known about the interactive effects of age and sex on symptoms, neurocognitive testing (NCT), and postural stability. Hypothesis/Purpose: The purpose of the study was to examine sex and age differences in symptoms, NCT, and postural stability following concussion. We hypothesized that high school and female athletes would have worse symptoms, NCT, and postural stability than college and male athletes, respectively. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 296 concussed athletes from a multistate, 2-year study were enrolled in this study. Participants completed the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) and Post-Concussion Symptom Scale (PCSS) at baseline and again at 2, 7, and 14 days after concussion. Participants completed the Balance Error Scoring System (BESS) at 1, 2, and 3 days after concussion. Results: Female athletes performed worse than male athletes on visual memory (mean, 65.1% and 70.1%, respectively; P = .049) and reported more symptoms (mean, 14.4 and 10.1, respectively) after concussion (P = .035). High school athletes performed worse than college athletes on verbal (mean, 78.8% and 82.7%, respectively; P = .001) and visual (mean, 65.8% and 69.4%, respectively; P = .01) memory. High school athletes were still impaired on verbal memory 7 days after concussion compared with collegiate athletes (P = .001). High school male athletes scored worse on the BESS than college male athletes (mean, 18.8 and 13.0, respectively; P = .001). College female athletes scored worse on the BESS than high school female athletes (mean, 21.1 and 16.9, respectively; P = .001). Conclusion: The results of the current study supported age differences in memory and sex differences in memory and symptoms and an interaction between age and sex on postural stability after concussion that warrant consideration from clinicians and researchers when interpreting symptoms, specific components of NCT, and postural stability tests. Future research should develop and assess interventions tailored to age and sex differences and include younger (<14 years) participants.

Concussion Symptoms and Recovery in Football Players

Source: Lau BC, Kontos AP, Collins MW, et al. Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players? Am J Sports Med. 2011; 39(11): 2311– 2318; doi: 10.1177/0363546511410655Researchers from the University of Pittsburgh sought to determine which on-field signs and symptoms are predictive of protracted (>21 days) versus rapid (≤7 days) recovery after a sport-related concussion in high school football players. Participants included 176 male high school football players (mean age 16.02±1.22 years) from the state of Pennsylvania who were diagnosed with a sport-related concussion by a trained sports medicine professional (ie, certified athletic trainer, team physician) during the preseason or regular season between 2002 and 2006. On-field signs and symptoms were observed and documented by the trained professional at the time of injury and included confusion, headache, loss of consciousness, post-traumatic amnesia, retrograde amnesia, imbalance, dizziness, visual problems, personality changes, fatigue, sensitivity to light/noise, numbness, and vomiting. Participants completed computerized neurocognitive testing using the Immediate Post-concussion Assessment and Cognitive Test (ImPACT)1 within an average 2.4 days after injury, and were followed until cleared to return to play by one of the study’s team of neuropsychologists using international clinical concussion management guidelines.Sixty-nine participants (40%) were lost to follow-up or did not return to football. Of the 107 evaluable athletes, 62 experienced rapid and 36 experienced protracted recovery. There were no significant differences between protracted and rapid recovery groups with regard to pre-injury history of headache, migraine, ADD/ADHD, learning disability, or more than one previous concussion. Mean recovery time in days for the rapid and protracted groups was 4.31 and 29.61, respectively, after correction for outliers. Nine participants’ recovery time fell between 7 and 21 days. The most common measured sign/symptom at the time of injury was headache (94.9%) and the least common was loss of consciousness (13.3%). Dizziness at the time of injury was associated with a 6.34 odds ratio (95% CI, 1.3–29.9; P=.01) of a protracted recovery from concussion. No other on-field signs and symptoms were associated with an increased risk of protracted recovery.The authors conclude that assessment of on-field dizziness may help identify high school football players at risk for a protracted recovery from concussion, which may allow clinicians to manage and treat concussion more effectively in these at-risk athletes.Dr LaBella has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.This study is important because it is the first to evaluate on-field signs and symptoms at the time of injury as possible predictors of prognosis after a sport-related concussion in adolescent football players. Previous studies focused on signs and symptoms at the time of initial clinical evaluation in an emergency department and up to several months after injury in heterogeneous groups of adults with sport- and non-sport-related concussions, with results demonstrating that persistent dizziness was associated with prolonged recovery.2–4 Since many high school football teams have health care providers on site to evaluate injuries and render care, information about signs and symptoms at the time of injury is valuable.The strengths of the current study include a uniform evaluation of all athletes by a team of neuropsychologists who applied the same specific set of criteria to define recovery and determine return-to-play status. Possible confounders such as pre-injury history of headache, learning disability, and previous concussion were accounted for in the analyses. The study’s limitations include a sample comprised of only male high school football players, so results cannot be extrapolated to older or younger players, females, or other sports. Additionally, 40% of athletes were lost to follow-up. Finally, balance was assessed in the enrolled athletes with Romberg, tandem walking, and heel-to-toe walking tests. Postural/balance tests specific for sport-related concussion, such as the Balance Error Scoring System (BESS), may be more sensitive measures of postural stability in athletes.5Despite these limitations, health care providers who evaluate and manage concussions in this population of athletes, especially those providing sideline care, will find these results clinically useful. Identifying dizziness at the time of the injury may allow health care providers to better inform athletes of what to expect regarding the timeframe for recovery and return to school and sports. Furthermore, previous studies2–4 suggest that prompt implementation of modalities to treat dizziness (eg, vestibular rehabilitation) may expedite recovery.