Single-leg Stance Time Research Articles

Effects of elastic taping on kyphosis and body balance in the elderly: a randomized crossover study

Kyphosis produces abnormal posture and reduced body balance in the elderly. Elastic tape may be useful at improving kyphotic posture and body balance. This study aims to evaluate the effects of elastic taping on kyphosis and body balance in the elderly. Ten elderly participants with degenerative kyphotic posture were recruited and randomly assigned to two groups (back taped with stretched elastic tape for 15 min and back taped with non-stretched elastic tape for 15 min). After a 1-h washout period, the groups were swapped over to receive the other intervention. The outcomes measured after each taping technique were Cobb’s angle measurement by inclinometer, perceived pain, and balance measurements by single leg stance test, time up and go test, center of gravity alignment (COG) and modified clinical test of sensory interaction on balance test (mCTSIB). There was a significant reduction in kyphotic angle and back pain in both the stretched and non-stretched taping groups (p < 0.05). We also found both taping techniques significantly reduced sway velocity on a foam surface with eyes closed and open (p < 0.05). However, there was no significant difference between taping groups for kyphotic angle, pain reduction or balance. The application of 15 min of stretched and non-stretched elastic tape in the elderly reduced kyphotic angle, back pain, and sway velocity while standing on foam surface in the mCTSIB test. If these changes persist over the long term (days and weeks) taping may be a useful intervention for elderly patients with kyphosis.

Effectiveness of magnetic therapy versus exercise in elderly patients with chronic mechanical neck pain: A randomized clinical trial

&lt;b&gt;Background:&lt;/b&gt; Mechanical neck pain (MNP) affects all age groups, it has a substantial physical, psychological, and economic impact, especially in elderly. This study aimed to evaluate effect of addition of magnetic therapy (MT) to exercise versus exercise therapy alone on neck pain (NP), proprioception, and balance in elderly patients with chronic MNP.&lt;br /&gt; &lt;b&gt;Materials &amp;amp; Methods:&lt;/b&gt; 50 elderly patients with chronic MNP were assigned to magnetic group (25 patients who practiced exercise program for 35-40 minutes/session three sessions per week for four weeks in addition exposure to MT for 20 minutes each session three sessions per week for four weeks) and control group (25 patients who practiced only the exercise program). The severity of pain, cervical joint position sense (JPS) and balance performance were measured by using the visual analogue scale (VAS) goniometer and the both single-leg stance time (SLST), and timed up and go (TUG) tests, respectively. ANOVA and Independent t-tests were used to determine significant differences within and between two groups for normal variables, whereas the Mann-Whitney and Kruskal-Wallis tests were used for not normal variables.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; The results show significant improvements in VAS, SLST (with open and closed eyes), TUG, and JPS after interventions in both groups, p-value &amp;lt;0.05, while addition of MT to exercise program induced only significant differences in VAS, SLST (with open &amp;amp; closed eyes), TUG, except JPS, p-value = 0.002, 0.047 &amp;amp; 0.037, 0.001, and 0.928 respectively, in favor to the magnetic group.&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; Multi-dimensional exercise program is effective in relieving NP and improving balance in elderly with MNP, addition of MT to exercise program could induce superior effects only on pain and balance for elderly patients with MNP.

Effects of cross-training on motor function and length of stay after total hip arthroplasty: A randomized controlled trial.

There is no consensus about which training methods will give better early outcomes after total hip arthroplasty (THA). To investigate the short-term effects of cross trainer exercise on physical function and walking ability following THA. Fifty patients who underwent THA were randomly allocated into two groups. The intervention program was started 3 days after surgery. The main physical function results were pain, hip range of motion, knee extensor strength, single-leg stance time, and walking performance test. In addition, the number of days of requiring to walk and the length of hospital stay were recorded. In the comparison between groups at discharge, the patients in the cross trainer group had significantly less hip pain while walking, improvement in knee extensor strength, increased single-leg stance time, as well as increased walking speed and stride length at discharge. The number of days required to walk and length of stay were also significantly lower in the intervention group. Conclusions: Cross trainer exercise commencing 3days postoperatively improves physical function and walking ability after THA.

Immediate effect of induced muscular fatigue on static and dynamic balance and core strength in male volleyball players

Introduction: Muscular fatigue causes impaired joint proprioception and postural control which can affect performance. Fatigue affects the capacity of the muscle to generate force which ultimately leads to injuries and diminish performance. The effect of fatigue on static and dynamic balance in volleyball players was inadequately known. Aim: To assess the effects of induced muscular fatigue on static and dynamic balance and core strength in volleyball players. Methodology: Twenty male volleyball players were included in the study according to inclusion criteria. Dynamic balance by functional reach test, static balance by single leg stance and strength of core were evaluated before and after inducing the fatigue. Fatigue was induced by asking the participant to perform the squats till RPE of 10. Results: On data analysis using paired t test, a marked decrease in the single leg stance time mean from 26.63 seconds before fatigue to 22.55 seconds after inducing fatigue (p&lt;0.05) was observed. A reduction in the functional reach distance covered by subjects from 31.8cms before fatigue to 29.33cms after inducing fatigue (p&lt;0.05) was observed. A decrease in the core muscle strength from 42.25 mm Hg before fatigue to 41.85 mmHg after fatigue (p&lt;0.05) was observed.

Center of pressure characteristics differ during single leg stance throughout pregnancy and compared to nulligravida individuals

BackgroundFalls are common during pregnancy and present potential for injury to the pregnant individual and the baby. Research questionDo center of pressure characteristics during single leg stance differ between participants during and after pregnancy and nulligravida participants in the presence and absence of visual input? MethodsNineteen pregnant participants completed testing during the second trimester, the third trimester, and 4–6 months post-partum. Matched, nulligravida females completed testing once. All participants performed single leg stance on a force platform on each limb for up to 20 s with eyes open and with eyes closed. Center of pressure characteristics were compared between pregnant and nulligravida females using three separate 2 × 2 mixed way ANOVAs, one for each pregnancy time point (second trimester, third trimester, and post-partum) with Bonferroni correction. ResultsPregnant females demonstrated smaller single leg stance time with eyes closed during the third trimester. During the second and third trimester, pregnant participants demonstrated smaller sway and sway velocity across eyes open and eyes closed conditions. During the third trimester and post-partum, pregnant participants demonstrated greater median frequency of the center of pressure data. Pregnant participants also demonstrated smaller sample entropy in the anteroposterior direction during the second and third trimesters and in the mediolateral direction during the second trimester. SignificanceThe decreased total sway and sway velocity observed during pregnancy may reflect rigidity or a protective strategy during single limb stance. Additionally, center of pressure data were less smooth and more repetitive during pregnancy indicating robust differences in postural control strategies and potentially increased fall risk. Because single limb stance is a component of many activities of daily living, the single limb stance task may have clinical utility for testing or training balance in this population with a goal of decreasing falls.

Clinical Tests for Predicting Fallers Among Ambulatory Patients with Amyotrophic Lateral Sclerosis: A Preliminary Cohort Study.

Few studies have examined falls and their predictors in patients with amyotrophic lateral sclerosis (ALS). The aim of this study was to survey fall incidence and to identify variables predicting the presence or absence of falls occurring within 3 months after discharge of patients with ALS from hospital. The following variables were evaluated in 14 patients with ALS: timed up and go test (TUG), functional reach test, 10-m comfortable gait speed, single-leg stance time, manual muscle test (MMT) scores for the lower limb, total modified Ashworth scale score for the lower limbs, fear of falling, and pull test score. The primary outcome variable was the occurrence of a fall within 3 months after discharge. The fall rate was calculated based on fall record forms. The specific circumstances of each fall were also recorded. Univariate and multiple regression analyses were used to identify fall predictors. Seven of the 14 ALS patients (50%) experienced a fall within 3 months. Five fallers reported experiencing a fall that had caused injury, and three reported experiencing a fall that had required a hospital visit. Univariate logistic regression analysis identified TUG time, gait speed and MMT of the ankle dorsiflexors as factors associated with falls (p = 0.02-0.04). Multiple linear regression analysis of fall numbers identified age and TUG time as predictor models (p = 0.03). TUG time and MMT of ankle dorsiflexors may help predict falls in ALS patients. Validation studies in larger cohorts are needed.

Effects of incorporating elliptical trainer exercise during rehabilitation on physical function and self-reported outcomes after total hip arthroplasty: a randomized controlled trial.

[Purpose] To investigate the effects of incorporating elliptical trainer exercise in early rehabilitation after total hip arthroplasty on physical function and self-reported outcomes. [Participants and Methods] Participants with independent gait prior to total hip arthroplasty underwent conventional postoperative physiotherapy and were divided into two groups. The intervention group additionally underwent elliptical trainer exercise, while the control group underwent a walking program. The main outcomes were low back and hip region pain, lower limb muscle strength, single-leg stance time, Timed Up & Go Test results, 10 m walking test results, hip disability and osteoarthritis outcome score, and modified fall efficacy scale score. These outcomes were evaluated preoperatively, at discharge, and at 1 and 3 months postoperatively. [Results] Fifty participants (including 40 females; age, 68.3 ± 10.8 years) participated in this study. Physical function evaluations showed a significant improvement in hip region pain during walking at discharge. Knee extensor strength, single-leg stance time, stride length, and walking speed were significantly greater in the intervention group at discharge and at 1 and 3 months postoperatively. The modified fall efficacy scale score significantly improved in the intervention group 1 month postoperatively. [Conclusion] Elliptical trainer exercise and conventional physiotherapy in the early postoperative period contribute to improved physical function and walking ability and improvement in the fear of falling.

Effect of Flat Feet on Static and Dynamic Balance in Adults

Background: The foot is the most distal segment in the lower extremity chain and represents a smallBOS upon which the body maintains balance. Minor biomechanical alterations in the support surfacecan influence postural-control strategies. However, the implications of a flat foot on balance havereceived little attention to date.Aimof the present study was to Evaluate the static and dynamic balancein individuals with flat feet.Method: A total of 40 subjects were recruited. Participants were assigned to 2 groups case groupand control group depending on foot type, as defined by the foot ink print method. Subjects weredivided into case groups and control groups. The static and dynamic balance were measured throughthe Unipedal stance test and star excursion balance test respectively.There was a significant correlation between single-leg stance time (with eyes opened and closed) andflat feet (p-value = &lt; .01). There was a significant correlation between reach distance in some direction(AM, MR, PM, P, AL, LL) with a flat foot (p-value &lt;0 .05).Conclusion: This study suggests that both static (single leg stance test) and dynamic (SEBT) balanceare affected in individuals with flat feet.

Functional Fitness and Cognition in Older Adults: A Mediation Model

Purpose Investigate the mediating effects of functional fitness on age-related cognitive decline in older adults. Design Cross-sectional study. Methods A sample of 427 community-dwelling older adults reported their medical history and sociodemographic characteristics. Functional fitness was assessed based on the sit-and-reach, grip strength, sit to stand, agility, single-leg stance time and the 6-minute walk tests. Cognitive performance was assessed using the Mini-Mental State Examination. Multilevel mediation models were applied to assess the relationship between age and cognitive status. Results In women, the relationship between age and cognitive decline (β = −0.08; P < 0.05) was attenuated by agility (β = −0.05; P < 0.05) and balance (β = −0.4; P < 0.05). However, none of the functional fitness tests affected the relationship between age and cognitive decline in older men. Conclusion Agility and balance attenuated the relationship between age and cognitive decline among older women by 50% and 40%, respectively.

The association between pain, balance, fall, and disability in patients with lumbar spinal stenosis with vascular claudication.

BackgroundThe effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC).MethodsSeventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively.ResultsAge and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia.ConclusionsThe findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.

Prediction of the Risk Factors of Knee Injury During Drop-Jump Landing With Core-related Measurements in Amature Basketball Players.

Purpose: To evaluate the relationship between specific aspects of core stability and knee injury risk factors during drop-jump (DJ) landing.Methods: Eighteen college-aged male amateur basketball players participated in the project. Kinetic and kinematic data for DJ tasks were collected with force plates and infrared cameras. Raw data were processed to calculate knee joint angles and joint moments during DJ landing. Different components of core stability were represented by the sit-ups in 20 s (SU), trunk extensor endurance, trunk flexion and extension range of motion, dominant extremity single-leg stance time (DLS), and dominant extremity single-leg hop distance, respectively.Methods: Correlation and regression were used to determine the relationship between jumping-related biomechanical parameters and core stability components.Results: SU shared significant variance with the peak moment of knee extension (PMKE, p < 0.05), the peak moment of knee abduction (PMKA, p < 0.05), and the angle of knee internal rotation at initial contact (AKRI, p < 0.05). DLS shared significant variance with the angular motion of knee internal rotation (AMKR, p < 0.05) and the AKRI (p < 0.01). SU and DLS together could explain 52% of the variance observed in the AKRI, and the result was significant.Conclusion: Core stability’s strength and motor control aspects played an essential role in preventing knee injury during DJ landing. An integrative training program addressing core strength and motor control could be considered for coaches and athletes to prevent knee injury through core training and conditioning.

Early outcomes of primary total hip arthroplasty with use of a smartphone-based care platform: a prospective randomized controlled trial.

The purpose of this study is to evaluate early outcomes with the use of a smartphone-based exercise and educational care management system after total hip arthroplasty (THA) and demonstrate decreased use of in-person physiotherapy (PT). A multicentre, prospective randomized controlled trial was conducted to evaluate a smartphone-based care platform for primary THA. Patients randomized to the control group (198) received the institution's standard of care. Those randomized to the treatment group (167) were provided with a smartwatch and smartphone application. PT use, THA complications, readmissions, emergency department/urgent care visits, and physician office visits were evaluated. Outcome scores include the Hip disability and Osteoarthritis Outcome Score (HOOS, JR), health-related quality-of-life EuroQol five-dimension five-level score (EQ-5D-5L), single leg stance (SLS) test, and the Timed Up and Go (TUG) test. The control group was significantly younger by a mean 3.0 years (SD 9.8 for control, 10.4 for treatment group; p = 0.007), but there were no significant differences between groups in BMI, sex, or preoperative diagnosis. Postoperative PT use was significantly lower in the treatment group (34%) than in the control group (55.4%; p = 0.001). There were no statistically significant differences in complications, readmissions, or outpatient visits. The 90-day outcomes showed no significant differences in mean hip flexion between controls (101° (SD 10.8)) and treatment (100° (SD 11.3); p = 0.507) groups. The HOOS, JR scores were not significantly different between control group (73 points (SD 13.8)) and treatment group (73.6 points (SD 13); p = 0.660). Mean 30-day SLS time was 22.9 seconds (SD 19.8) in the control group and 20.7 seconds (SD 19.5) in the treatment group (p = 0.342). Mean TUG time was 11.8 seconds (SD 5.1) for the control group and 11.9 (SD 5) seconds for the treatment group (p = 0.859). The use of the smartphone care management system demonstrated similar early outcomes to those achieved using traditional care models, along with a significant decrease in PT use. Noninferiority was demonstrated with regard to complications, readmissions, and ED and urgent care visits. This technology allows patients to rehabilitate on a more flexible schedule and avoid unnecessary healthcare visits, as well as potentially reducing overall healthcare costs. Cite this article: Bone Joint J2021;103-B(7 Supple B):91-97.

Effects of functional movement screen training in high-school baseball players: A randomized controlled clinical trial.

Background:In recent years, the functional movement screen (FMS) and FMS training have attracted attention as a means of preventing injury, but no studies have examined the effect of such training in high-school baseball players. The aim of this study was to clarify the effect of FMS training on FMS score, physical function and baseball performance in high-school baseball players.Methods:Subjects in this randomized controlled clinical trial were high-school male baseball players assigned to either an FMS training group (intervention group) or a control group. The intervention group performed FMS training 4 times per week for 12 weeks. FMS ability, physical function, and baseball performance were measured prior to the intervention, 8, 12, and 24 weeks after the intervention in the subjects’ school environment.Results:A total of 71 baseball players aged 15 to 17 years were recruited and assigned to either an intervention group (n = 37) or control group (n = 34). There was no significant difference in the characteristics of participants between the 2 groups. Most FMS scores improved to 12 weeks after continued training. In the intervention group compared with the control group, deep squat, hurdle step, inline lunge, active straight leg raise, trunk stability push-up and rotary stability FMS score, total FMS score and eyes closed single leg stance time significantly increased after 8 weeks of training. While hurdle step, inline lunge, active straight leg raise, trunk stability push-up, total FMS score, and eyes closed single leg stance time significantly increased, pitching ball speed significantly decreased at the end of the 12 week training period. Eyes closed single leg stance time and feeling of fatigue significantly improved 12 weeks after training. The number of subjects who scored less than 14 for the total FMS score in the intervention group compared with control group were significantly less after 8 and 12 weeks of FMS training.Conclusion:FMS training for 8 weeks contributes to improving FMS scores for high-school baseball players, but FMS scores go down if FMS training is not continued.Trial registration:University Hospital Medical Information Network Center, Tokyo, Japan: UMIN000027553. Registered on May 30, 2017.

Effects of low vs. high frequency local vibration on mild-moderate muscle spasticity: Ultrasonographical and functional evaluation in patients with multiple sclerosis

BackgroundLocal vibration (LV) is a physiotherapy application that aims to reduce spasticity. The study aimed to compare the effects of 50 Hz vs. 100 Hz LV on mild-moderate spasticity, functional performance and muscle architecture. MethodsThirty-three patients were randomly divided into three groups: 50 Hz LV group, 100 Hz LV group and the control group. Physical therapy was applied for one hour a day, three days a week, for a total of eight weeks. LV was applied to the right and left medial gastrocnemius muscles for five minutes. Clinical (spasticity, ankle joint position sense, balance, gait) and ultrasonographic (gastrocnemius fascicle length and pennation angle) measurements were performed before and after treatment. ResultsThe study was completed with 27 patients. The decrease in spasticity and the increase in fascicle length were found to be statistically significant in the 50 Hz group (both p<0.05). Ankle joint position sense, single-leg stance time, limits of stability/postural sway range in the medio-lateral direction significantly improved in the vibration treatment groups (all p<0.05). The antero-posterior limits of stability and postural sway showed significant improvement in all groups (all p<0.05). While the 50 Hz group showed significant improvement for all walking parameters; velocity, step length and base of support values improved in the 100 Hz group (all p<0.05). The exercise group showed significant improvement only for single support and stance phase percentages of the gait cycle (both p<0.05). According to between group comparisons, significant difference was found only in medio-lateral limits of stabillity (p<0.05). Medio-lateral limits of stabillity scores were better for the 50 Hz group than the 100 Hz and exercise group. ConclusionOur findings show that LV does not have any substantial effect except for medio-lateral limits of stability. Clinical Trial NumberNCT04192786.

A Depth Camera-Based, Task-Specific Virtual Reality Rehabilitation Game for Patients With Stroke: Pilot Usability Study.

BackgroundThe use of virtual reality is popular in clinical rehabilitation, but the effects of using commercial virtual reality games in patients with stroke have been mixed.ObjectiveWe developed a depth camera–based, task-specific virtual reality game, Stomp Joy, for poststroke rehabilitation of the lower extremities. This study aims to assess its feasibility and clinical efficacy.MethodsWe carried out a feasibility test for Stomp Joy within representative user groups. Then, a clinical efficacy experiment was performed with a randomized controlled trial, in which 22 patients with stroke received 10 sessions (2 weeks) of conventional physical therapy only (control group) or conventional physical therapy plus 30 minutes of the Stomp Joy intervention (experimental group) in the clinic. The Fugl-Meyer Assessment for Lower Extremity (FMA-LE), Modified Barthel Index (MBI), Berg Balance Scale (BBS) score, single-leg stance (SLS) time, dropout rate, and adverse effects were recorded.ResultsThis feasibility test showed that Stomp Joy improved interest, pressure, perceived competence, value, and effort using the Intrinsic Motivation Inventory. The clinical efficacy trial showed a significant time-group interaction effect for the FMA-LE (P=.006), MBI (P=.001), BBS (P=.004), and SLS time (P=.001). A significant time effect was found for the FMA-LE (P=.001), MBI (P<.001), BBS (P<.001), and SLS time (P=.03). These indicated an improvement in lower extremity motor ability, basic activities of daily living, balance ability, and single-leg stance time in both groups after 2 weeks of the intervention. However, no significant group effects were found for the FMA-LE (P=.06), MBI (P=.76), and BBS (P=.38), while a significant group interaction was detected for SLS time (P<.001). These results indicated that the experimental group significantly improved more in SLS time than did the control group. During the study, 2 dropouts, including 1 participant who fell, were reported.ConclusionsStomp Joy is an effective depth camera–based virtual reality game for replacing part of conventional physiotherapy, achieving equally effective improvement in lower extremity function among stroke survivors. High-powered randomized controlled studies are now needed before recommending the routine use of Stomp Joy in order to confirm these findings by recruiting a large sample size.

Balance, gait, and navigation performance are related to physical exercise in blind and visually impaired children and adolescents

Self-motion perception used for locomotion and navigation requires the integration of visual, vestibular, and proprioceptive input. In the absence of vision, postural stability and locomotor tasks become more difficult. Previous research has suggested that in visually deprived children, postural stability and levels of physical activity are overall lower than in sighted controls. Here we hypothesized that visually impaired and blind children and adolescents differ from sighted controls in postural stability and gait parameters, and that physically active individuals outperform sedentary peers in postural stability and gait parameters as well as in navigation performance. Fourteen blind and visually impaired children and adolescents (8–18 years of age) and 14 matched sighted individuals took part. Assessments included postural sway, single-leg stance time, parameters of gait variability and stability, self-reported physical activity, and navigation performance. Postural sway was larger and single-leg stance time was lower in blind and visually impaired participants than in blindfolded sighted individuals. Physical activity was higher in the sighted group. No differences between the group of blind and visually impaired and blindfolded sighted participants were observed for gait parameters and navigation performance. Higher levels of physical activity were related to lower postural sway, longer single-leg stance time, higher gait stability, and superior navigation performance in blind and visually impaired participants. The present data suggest that physical activity may enhance postural stability and gait parameters, and thereby promote navigation performance in blind and visually impaired children and adolescents.

Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes.

Background: Ankle sprains are common among physically active individuals, especially among athletes. Majority of those who suffer ankle sprains have residual symptoms including pain, episodes of giving way, compromised proprioception and neuromuscular control, and re-injury leading to chronic ankle instability. The aim of this study was to see the effect of chronic ankle sprain on pain, range of motion, proprioception, and, static and dynamic balance among athletes. Methods: A total of 80 athletes, aged 18 to 25 years, involved in track-and-field sports were invited to participate in this study. They were divided in two groups. Athletes with history of grade 1 or 2 ankle sprain on either side requiring medical care who reported at least three episodes of ankle giving way in past 12 months were included in group A. An equal number of healthy athletes without any history of ankle sprain or injury in the lower limbs in the past one year matched by sex, age, height, weight, and limb dominance, were included in group B (control). Outcome measures: Participant’s pain, range of motion, proprioception and balance (static and dynamic) was measured using visual analog scale, half circle goniometer, degree of foot position sense, single leg stance time and Y-balance test respectively. Results: Although there were no differences in the active ankle joint range of motion (p > 0.05) in comparison to the control group, athletes with chronic ankle sprain reported mild pain and statistically significant (p < 0.05) deficits in foot proprioception, static and dynamic balance. Conclusions: Deficits in foot proprioception, static and dynamic balance even one year after the ankle sprain could be the reason for limitations in the dynamic defense system of the joint that predisposes to recurrent injury and instability. It is essential to understand the normal clinical course and risk factors for athletes who sustain sprain before devising a long term comprehensive rehabilitation program that focuses on mechanical and functional insufficiencies in order to improve their functional performance and prevent the risk of recurrent sprain.

Static and Dynamic Balance in Adults Undergoing Lumbar Spine Surgery: Screening and Prediction of Postsurgical Outcomes.

Balance and fall risk before and after lumbar surgery was assessed to determine whether balance at baseline predicts long-term postsurgical outcomes. Forty-three patients in the United States and Israel performed the single-leg stance (SLS) test, four square step test (FSST), and 8-foot up-and-go (8FUG) test before and 2 to 4 months after lumbar spine surgery. They completed the Oswestry Disability Index (ODI) and pain rating before and 12 months after lumbar surgery. From baseline to follow-up, the SLS time was 3.74 seconds longer (P = 0.01), the FSST time was 1.94 seconds faster (P < 0.001), and the 8FUG time was 1.55 seconds faster (P = 0.02). Before surgery, 26% of the patients were considered high fall risk according to the FSST and 51% according to the 8FUG. Postsurgery, all patients could complete the physical tests, but 26% remained at high fall risk according to the 8FUG and 7.5% according to the FSST. The three physical measures together explained 30% of the variance in postsurgical ODI scores (P = 0.02). Age was not correlated with performance. Risk of falling is higher than surgeons suspect. Balance tests (ie, SLS, FSST, and 8FUG) are quick and easy to administer. The findings support the importance of screening for balance and fall risk in adults undergoing lumbar spine surgery.

Adapted physical activity in community-dwelling adults with neurological disorders: design and outcomes of a fitness-center based program

Purpose To describe and evaluate an adapted physical activity-based program (APA-program) designed for community-dwelling patients with neurological diseases in local fitness centers. Materials and methods The APA-program consisted of individual and group activities supervised by an adapted physical activity (APA) instructor twice a week for 6 months. Clinical evaluations before and after the APA-program included strength tests on gym machines, the six-minute walk test (6MWT), the single-leg stance test, and the Short Form-36 (SF-36). Results Between January 2017 and May 2019, 79 individuals participated in the APA-program (33 women, mean age 59 ± 14 years, 47 stroke, 13 multiple sclerosis, and 19 other neurological diseases). All physical outcomes improved significantly: upper body strength increased by 49%, lower body strength by 37%, 6MWT by 22%, single-leg stance time by 86%, and SF-36 Mental and Physical scores by 23%. Sixty-eight percent of participants completed the 6-month program and 83% of completers then purchased a one-year subscription in the fitness center. Conclusions The 6-month APA-program improved participant’s physical abilities and quality of life. More than half of participants decided to subscribe personally to the fitness center at the end of the program, supporting the development of community APA-programs for people with chronic neurological diseases, in collaboration with rehabilitation hospitals. Implications for rehabilitation A physical activity-based-program implemented in a fitness center is effective in improving physical fitness and quality of life in people suffering from neurological disorders such as stroke and multiple sclerosis. Close coordination between rehabilitation hospitals and local fitness centers, training by skilled adapted physical activity instructors and group activities are critical determinants of successful participation.

Increased Time Difference between Imagined and Physical Walking in Older Adults at a High Risk of Falling

Walking motor imagery ability is thought to be associated with a fear of falling; however, no studies have compared fall risk and motor imagery ability. This study aimed to ascertain the time difference between imagined and physical walking in older adults at low and high risks of falling. Motor imagery ability was assessed using mental chronometry, which measures the imagined time required for movement. Participants included 31 older adults classified as having a high (n = 15) or low (n = 16) risk of falling based on single leg stance time. The time required for imagined and physical walking was measured using 5 m long walkways with three different widths (15, 25, and 50 cm), and the temporal errors (absolute and constant error) were compared. Physical walking time was significantly longer in the high-risk group than in the low-risk group for the 15 and 25 cm wide walkways. The absolute error between the imagined and physical walking times was significantly larger in the high-risk group than in the low-risk group for the 15 and 25 cm wide walkways. There was also a significant difference in the constant error between the high- and low-risk groups between the imagined and physical walking times for all three walkways. Older adults who may be at a higher risk of falling showed longer walking times during action execution but overestimated their performance (i.e., they believe they would be faster) during motor imagery. Therefore, the time difference between imagined and physical walking could, in part, be useful as a tool for assessing fall risk based on motor imagery.