Single-leg Stance Research Articles

Mobility screening for fall prediction in the Canadian Longitudinal Study on Aging (CLSA): implications for fall prevention in the decade of healthy ageing.

BackgroundGuidelines for fall prevention in older adults recommend mobility screening for fall risk assessment; however, there is no consensus on which test to use and at what cutoff. This study aimed to determine the accuracy and optimal cut-off values of commonly used mobility tests for predicting falls in the Canadian Longitudinal Study on Aging (CLSA).MethodsMobility tests at baseline included the Timed Up and Go (TUG), Single Leg Stance (SLS), chair-rise and gait speed. Inclusion criteria were: age ≥ 65 years and meeting first-level fall screening criteria (i.e. history of a fall or mobility problem) at baseline. Accuracy of fall prediction at 18-months for each test was measured by the area under the receiver operating curve (AUC).ResultsOf 1,121 participants that met inclusion criteria (mean age 75.2 ± 5.9 years; 66.6% women), 218 (19.4%) reported ≥one fall at 18 months. None of the tests achieved acceptable accuracy for identifying individuals with ≥one fall at follow-up. Among women 65–74 and 75–85 years, the TUG identified recurrent fallers (≥two falls) with optimal cut-off scores of 14.1 and 12.9 s (both AUCs 0.70), respectively. Among men 65–74 years, only the SLS showed acceptable accuracy (AUC 0.85) for identifying recurrent fallers with an optimal cutoff of 3.6 s.ConclusionsOur findings indicate that commonly used mobility tests do not have sufficient discriminability to identify fallers in a population-based sample of community-dwelling older adults. The TUG and SLS can identify recurrent fallers; however, their accuracy and cut-off values vary by age and sex.

Associations between measures of physical fitness and cognitive performance in preschool children

BackgroundGiven that recent studies report negative secular declines in physical fitness, associations between fitness and cognition in childhood are strongly discussed. The preschool age is characterized by high neuroplasticity which effects motor skill learning, physical fitness, and cognitive development. The aim of this study was to assess the relation of physical fitness and attention (including its individual dimensions (quantitative, qualitative)) as one domain of cognitive performance in preschool children. We hypothesized that fitness components which need precise coordination compared to simple fitness components are stronger related to attention.MethodsPhysical fitness components like static balance (i.e., single-leg stance), muscle strength (i.e., handgrip strength), muscle power (i.e., standing long jump), and coordination (i.e., hopping on one leg) were assessed in 61 healthy children (mean age 4.5 ± 0.6 years; girls n = 30). Attention was measured with the “Konzentrations-Handlungsverfahren für Vorschulkinder” [concentration-action procedure for preschoolers]). Analyses were adjusted for age, body height, and body mass.ResultsResults from single linear regression analysis revealed a significant (p < 0.05) association between physical fitness (composite score) and attention (composite score) (standardized ß = 0.40), showing a small to medium effect (F2 = 0.14). Further, coordination had a significant relation with the composite score and the quantitative dimension of attention (standardized ß = 0.35; p < 0.01; standardized ß = − 0.33; p < 0.05). Coordination explained about 11% (composite score) and 9% (quantitative dimension) of the variance in the stepwise multiple regression model.ConclusionThe results indicate that performance in physical fitness, particularly coordination, is related to attention in preschool children. Thus, high performance in complex fitness components (i.e., hopping on one leg) tends to predict attention in preschool children. Further longitudinal studies should focus on the effectiveness of physical activity programs implementing coordination and complex exercises at preschool age to examine cause-effect relationships between physical fitness and attention precisely.

Association between balance single-leg stance and fatigue in adult male futsal athlete.

Association between balance single-leg stance and fatigue in adult male futsal athlete.

Thirty-Second Single-Leg Stance Identifies Impaired Postural Control in Children After Concussion: A Preliminary Report.

Objective and expedient assessments of standing postural control incorporating static and dynamic tasks are necessary for identifying subtle motor deficits and clearing children to return to high-risk activities after concussion. The Revised Physical and Neurological Examination for Subtle Signs (PANESS) gaits and stations tasks evaluate both static and dynamic aspects of postural control. While the PANESS gaits and stations subscale is sensitive to concussion in youth, the benefit of each specific task for this purpose is unknown. This study evaluated whether specific PANESS tasks identify postural impairments after youth concussion. Cross-sectional study. Academicallyaffiliated research laboratory. Sixty youth, ages 10-17years, comprised 3 groups: (1)youth symptomatic from concussion (4-14d postinjury [n = 18]), (2)clinically-recovered youth (27-122d postinjury [n = 15]), and (3)age- and gender-matched never-concussed controls (n = 27). PANESS gaits and stations tasks (6 dynamic and 3 static) at the time of the initial research visit. Kruskal-Wallis statistic identified a significant main effect of group on standing on one foot (a 30-s task). Both symptomatic and clinically-recovered youth showed deficits on standing on one foot relative to controls. Single-leg tasks of longer duration may maximize the ability to detect residual postural deficits after concussion and can be readily incorporated in targeted sport rehabilitation protocols.

Mechanical and Sensorimotor Outcomes Associated With Talar Cartilage Deformation After Static Loading in Those With Chronic Ankle Instability.

Those with chronic ankle instability (CAI) demonstrate deleterious changes in talar cartilage composition, resulting in alterations of talar cartilage loading behavior. Common impairments associated with CAI may play a role in cartilage behavior in response to mechanical loading. To identify mechanical and sensorimotor outcomes that are linked with the magnitude of talar cartilage deformation after a static loading protocol in patients with and those without CAI. Cross-sectional study. Laboratory setting. Thirty individuals with CAI and 30 healthy individuals. After a 60-minute off-loading period, ultrasonographic images of the talar cartilage were acquired immediately before and after a 2-minute static loading protocol (single-legged stance). Talar cartilage images were obtained and manually segmented to enable calculation of medial, lateral, and overall average talar thickness. The percentage change, relative to the average baseline thickness, was used for further analysis. Mechanical (ankle joint laxity) and sensorimotor (static balance and Star Excursion Balance Test) outcomes were captured. Partial correlations were computed to determine associations between cartilage deformation magnitude and the mechanical and sensorimotor outcomes after accounting for body weight. In the CAI group, greater inversion laxity was associated with greater overall (r = -0.42, P = .03) and medial (r = -0.48, P = .01) talar cartilage deformation after a 2-minute static loading protocol. Similarly, poorer medial-lateral static balance was linked with greater overall (r = 0.47, P = .01) and lateral (r = 0.50, P = .01) talar cartilage deformation. In the control group, shorter posterolateral Star Excursion Balance Test reach distance was associated with greater lateral cartilage deformation (r = 0.42, P = .03). No other significant associations were observed. In those with CAI, inversion laxity and poor static postural control were moderately associated with greater talar cartilage deformation after a 2-minute static loading protocol. These results suggest that targeting mechanical instability and poor balance in those with CAI via intervention strategies may improve how the talar cartilage responds to static loading conditions.

Postural control during single leg stance in individuals with clinical indication for combined reconstruction of the anterior cruciate and the anterolateral ligaments of the knee: a cross-sectional study

BackgroundSeveral studies have shown persistent postural control deficits and rotatory instability in patients after isolated Anterior Cruciate Ligament (ACL) reconstruction. There is evidence to support that the Anterolateral Ligament (ALL) plays an important role in the remaining anterolateral rotatory laxity of the knee. There are no further evidences in order to understand how patients with a combined ACL + ALL reconstruction surgery indication behave regarding postural control. The aim of this cross-sectional study was to assess if patients with a clinical indication for the combined ACL + ALL surgery showed a deficient postural control in single leg stance compared to subjects with a regular ACL reconstruction indication and to a control group.MethodsAn assessment of static postural control on single leg stance was performed on a force plate, with eyes open and closed, and the center of pressure (COP) displacement variables were analyzed: maximum and mean amplitude in anteroposterior (AP) and in mediolateral (ML) direction; mean velocity of displacement and area of displacement. Eighty-nine male individuals participated and were divided into 3 groups: ACL Group, ACL + ALL Group and Control Group.ResultsThe ACL+ ALL Group showed significantly greater COP displacement in most variables in the injured leg for the eyes closed test, compared to the ACL Group, as detailed: Total ML displacement (9.8 ± 6.77 vs. 13.98 ± 6.64, p < 0.001); Mean ML displacement (2.58 ± 2.02 vs. 3.72 ± 1.99, p < 0.001); Total AP displacement (9.5 ± 3.97 vs. 11.7 ± 3.66, p = 0.001); Mean AP displacement (1.77 ± 0.87 vs. 2.27 ± 0.86, p = 0.001); Area of displacement (111.44 ± 127.3 vs. 183.69 ± 131.48, p < 0.001).ConclusionSubjects with a clinical indication for ACL + ALL combined reconstruction surgery showed increased COP displacement compared to patients with indication for an ACL isolated reconstruction surgery.

Sexual Dimorphism Impact on the Ground Reaction Force Acting on the Mediolateral Direction During Level Walking: Hip Abductor Muscle Biomechanics and Its Correlation to GRF Moment Arm.

The female pelvis morphology represents an evolved compensation between two opposing needs: a broad pelvis enough to deliver a sizeable brained offspring while remaining narrow enough to allow for effective bipedal gait. The precise expectation of hip abductor force generation is critical in anthropological studies and experimental practice of human stride mechanics. Hip implants and surgical procedures for hip anatomy reconstruction are based on the static single-leg stance paradigm. The current work investigated the impact of sexual dimorphism on the ground reaction force (GRF) acting on the mediolateral direction during level walking, emphasizing the difference in hip abductor muscle biomechanics and its correlation to ground reaction force moment arm, R. The ground reaction force in the mediolateral direction, hip abduction and adduction moments during the gait cycle and ground reaction force moment arm, R were measured. The current study concludes that the male individuals exhibit significantly higher mass-specific mediolateral ground reaction force during level walking. In contrast, hip abductor moments/kg body weight, medialization of the trochanter, R, and hip coronal were more significant in female individuals. We conclude that increased abductor moment and medialization of the greater trochanter will increase R, hip coronal and decrease abductor moment arm, r, in female individuals, affecting the effective mechanical advantage (EMA) of hip abductors in single-limb stance during level walking.

Differences in lower limb muscle activation between global and selective instability devices in single-leg stance in healthy active subjects.

BackgroundBalance and strength training are frequent strategies to address lower limb injuries, including ankle injuries, which are usually performed in single-leg stance on global instability devices, producing generalized muscular activation of the lower limb. In this context, new specific instability devices arise from the need to selectively work the ankle, specifically the peroneus longus. This study aimed to compare the EMG muscle activation of the peroneus longus, as well as other lower limbs muscles, in a single-leg stance on different balance training devices (BOSU, wobble board, power board, and Blackboard) in standing or squatting positions.MethodsTwenty healthy recreationally trained subjects participated in the study. Subjects performed three repetitions of 15 s (one for familiarization and two for measurement) in standing and squatting positions on the floor, BOSU, wobble board, power board, and Blackboard. Surface electromyography (EMG) was used to record activity of the peroneus longus, soleus, gastrocnemius medialis, tibialis anterior, rectus femoris, and gluteus maximus.ResultsThe main outcome was that no differences were found for the peroneus longus normalized EMG, neither between devices (p = 0.09) nor between conditions (p = 0.11), nor in the interaction between them (p = 0.16). For the normalized EMG of the other muscles, there were multiple differences between devices and conditions. Of the devices studied, the Blackboard was the one that implied a lower activation of the lower limb muscles and a lower degree of instability, activating the peroneus longus similarly to global instability devices. The BOSU and wobble board achieved high levels of EMG muscle activation for most muscles of the lower limbs. Therefore, they should be considered as potential devices for work in highly unstable conditions or when high activation levels are sought.

Stochastic failure analysis of proximal femur using an isogeometric analysis based nonlocal gradient-enhanced damage model

Background and objectiveMedical imaging-based finite element methods are more accurate tools for fracture risk prediction than the traditional aBMD based methods. However, these methods have drawbacks like geometric errors, high computational cost, mesh-dependent results, etc. In this article, the authors have proposed an isogeometric analysis-based nonlocal gradient-enhanced damage model to overcome some of these issues. Moreover, there are uncertainties in the values of input parameters for such analysis due to various measurement errors. Hence, stochastic analysis is performed to quantify the effect of these parametric uncertainties on the fracture behavior of the proximal femur. MethodsComputed Tomography images of a patient are used to create a 2D proximal femur model with a heterogeneous description of material properties. A numerical model based on gradient-enhanced nonlocal continuum damage mechanics is used for fracture analysis of proximal femur to overcome the issues related to mesh dependency in traditional continuum damage mechanics models. Further, a multipatch isogeometric solver is developed to solve the governing equations. Monte Carlo simulations are used to understand the effect of parametric uncertainties on the fracture behavior of the proximal femur. ResultsThe developed numerical framework is used to solve the fracture problem of proximal femur under single leg stance loading conditions. The obtained results are validated by comparing the load-displacement response and the crack path with that given in the literature. Stochastic analysis is performed by considering a ±5% variation in the elastic modulus, damage initiation strain, and the neck-shaft angle values. ConclusionThe proposed numerical framework can correctly predict the damage initiation and propagation in a proximal femur. The results reveal that the heterogeneous nature of material properties of bone plays a significant role in determining the fracture characteristics of the proximal femur. Further, the results of the stochastic analysis reveal that the parametric uncertainties in the neck-shaft angle have a much more significant influence on the results of the analysis than the parametric uncertainties in the elastic modulus and damage initiation strain.

Acute effect of inhibitory kinesio tape on range of motion, dynamic balance, and gait in athletes with hamstring shortness

ObjectiveThe goal of the present study was to investigate the acute effects of kinesio tape on range of motion (ROM), perceived stiffness, and kinetic parameters in athletes with hamstring shortness. MethodsFifteen athletes with bilateral hamstring shortness were divided randomly into intervention (inhibitory application of kinesio tape plus static stretching) and control (static stretching) groups. Outcome measures were straight leg raise (SLR), active knee extension (AKE) tests for ROM, visual analogue scale (VAS) for perceived stiffness and kinetic parameters which are recorded and calculated by Moticon SCIENCE insoles during four functional performance task of single leg stance (SLS), slow and fast walking and running. ResultsROM, stiffness, and kinetic parameters examined with insoles during SLS and walking tasks changed in both the intervention and control groups (P < 0.05). Furthermore, study groups were different in some variables. The increase in ROM in SLR test and the decrease in perceived stiffness in the intervention group were more evident than in the control group (P = 0.03 and P = 0.001, respectively). There was no difference between the intervention and control groups for the variables in SLS test, slow and fast walking, and running tasks, except for the mean swing duration (MSWD) (P = 0.002) in fast walking. ConclusionThe static stretching alone and the kinesio tape plus static stretching could change many of the kinetic parameters during walking and balance tasks, but the rate of these changes were more significant with kinesio tape plus stretching compared to the stretching alone.

Multidomain Integrated Exercises Decreased the Risk of Falls of Community-Dwelling Older Adults

Aims: To determine effects of a multidomain health promotion (MDHP) scheme for the community elderly in reducing fall risks. Methods: Database from older persons using the scheme was analyzed and categorized as high and low risk of fall groups retrospectively. The main measures included the 30-second chair-stand, 8-ft Up-and-Go, and single-leg stance tests. The effects of training were examined and compared across different age groups. Results: Balance was significantly improved in the high-risk group, especially the young-old and old-old groups. Conclusions: The MDHP program at least 1 hour per week for the older people was promising in reducing the risk of falls.

The Emergence of Dry Needling in Stroke Rehabilitation

The management of stroke, acute revascularization and rehabilitation techniques have taken a giant leap in the current decade. The presence of neurological deficits, spasticity and pain are the common limiting factors in post-stroke patients. The various rehabilitation measures in stroke are focused on improving the trio. Spasticity, in a post-stroke patient, is disabling and can be managed using oral pharmacological agents, botulinum toxin, intrathecal baclofen. The use of needle therapy, dry needling, which was commonly used in the management of myofascial pain syndromes has emerged useful in the management of spasticity. Further recent evidence has shown it to be useful in the other dimensions of stroke rehabilitation. Dry Needling is a skilled intervention, that is performed by trained personnel using a filiform needle. It can be performed superficially or deep. The speculative mechanisms by which dry needling reduces spasticity include inducing stretch in the muscle and afferent modulation of the sensory information from the muscle. It improves blood flow and oxygenation, reduces pain through central and peripheral mechanisms. (1)&#x0D; The use of dry needling in neurology has evolved from its use in the management of myofascial pain to spasticity in spastic tetra paresis and stroke rehabilitation. In post-stroke patients, dry needling has been used in the management of post-stroke spasticity, balance, post-stroke pain. In the management of spasticity, dry needling using ‘pistoning technique’ in the lower limbs (gastrocnemius, tibialis posterior) and upper limbs (shoulder, elbow and wrist) revealed improved scores in modified modified Ashworth scale (MMAS) that translated to improved gait and range of upper limb motion respectively. The dry needling was performed for 1 minute in each muscle studied. However, the number of sessions varied from a single session to 8-week therapy between studies. In the management of balance, the dry needling of the involved tibialis posterior muscle improved the balance as measured by single-leg stance, balance component of Fugl-Meyer scale and dynamic posturography. The improvement in the above measures is also shown to improve the functional outcome of post-stroke patients in Barthel index, 10-metre walk test, timed up and go test. The dry needling is shown to reduce pain including post-stroke shoulder pain by reducing the pain threshold. The above effects of dry needling were also evident in ultrasound assessment of the intervened gastrocnemius muscle that showed improved muscle length, reduced mean muscle thickness and angle of pennation. (1-3)&#x0D; The dry needling has also been studied in post-stroke rehabilitation as a component of the multimodal approach. The use of dry needling in conjunction with electrical stimulation of the muscle is shown to produce persistent improvement in the tone of the muscle. The adverse events noted following the use of dry needling include post interventional muscle soreness, bleeding, bruise and pain during the intervention. Major side effects such as loss of consciousness are rare and hence dry needling serves as a safe therapeutic option in the rehabilitation of post-stroke patients. (1-3)&#x0D; Hence dry needling is a safe, cost-effective technique that can be used in the management of post-stroke spasticity, balance, pain that translates to improved functional outcomes. However, further evidence is required to establish the efficacy of this promising technique in the management of post-stroke rehabilitation.

Maximal lateral ligament strain and loading during functional activities: Model-based insights for ankle sprain prevention and rehabilitation

BackgroundAlthough it is generally accepted that sports activities present a high risk of lateral ligament injury, the extent to which ligaments are loaded during functional activities is less explored. This is relevant when considering ankle sprain prevention and staged rehabilitation following ligament sprain or reinforcing surgery. Therefore, anterior talofibular ligament, calcaneofibular ligament and posterior talofibular ligament strain and loading were evaluated, based on a newly developed loading index, during movements executed during daily life and rehabilitation. MethodsThree-dimensional motion analysis data was acquired in 10 healthy volunteers during eleven different movements and processed using musculoskeletal modelling. Maximal lateral ligament strain and ligament loading, based on an new index accounting for the ankle and subtalar moment magnitude, ligament strain magnitude and duration, were calculated and statistically compared to ligament strain and loading during walking and a reference clinical (talar tilt) test. FindingsAnterior talofibular, calcaneofibular and posterior talofibular lateral ligament loading were highest during vertical drop jumps, medio-lateral single leg hops and running. Additionally, anterior talofibular loading was high during stair descending, calcaneofibular loading during single leg stance without visual feedback and posterior talofibular loading during anterior single leg hops. During the clinical test, anterior talofibular and calcaneofibular ligament strain were substantially lower than the maximal strain during different movements. InterpretationOur results allow classification of exercises according to the ligament loading index and maximal strain, thereby providing objective data to progressively stage ligament loading during rehabilitation.

The Effects of Instrumental Balance Training on Balance in Individuals with Unilateral Transtibial Amputation: A Pilot Study

ABSTRACT Introduction With the loss of a lower limb, an individual with amputation may face impaired gait and balance. Different rehabilitation techniques can be used to deal with those functional disabilities. The purpose of this study was to determine whether computerized balance training could have any possible effects on balance in individuals with unilateral transtibial amputation. Materials and Methods A total of 16 subjects who used a prosthesis in their daily life and were between 18 and 65 years of age were included in the study. Individuals were randomly divided into two groups: control group (CG) (n = 7) trained with traditional prosthetic rehabilitation and the experimental group (EG) (n = 9) trained with computerized balance training for five sessions for 2 weeks. Percentage of prosthetic weight bearing (PWB) timed up and go test (TUG), single-leg stance test (SLST), postural sway score, and limits of stability (LoS) were evaluated at baseline and posttreatment. Results No significant differences were observed in between-group comparisons after treatment. Within-group comparison showed that PWB, SLST, and LoS score increased in EG, whereas only PWB increased in CG. Conclusions Similar results were revealed with both computerized and traditional prosthetic training. Although there were no significant differences in between-group comparisons, computerized balance training improved the amputated side single-leg stance and stability limits, which are highly related to fall risk in individuals with amputation. Clinical Relevance Clinical relevance: Usage of computerized balance training can be helpful to improve single-leg stance and LoS in individuals with transtibial amputation.

Validity and reliability of performance tests as balance measures in patients with total knee arthroplasty

PurposeThis study aimed to investigate validity and reliability of the Timed Up and Go Test (TUG), 10 Meter Walk Test (10MWT), Single Leg Stance Test (SLST), 2 Minute Walk Test (2MWT), and Five Times Sit-to-Stand Test (5xSST) for evaluating balance in patients with total knee arthroplasty (TKA).Materials and MethodsThis cross-sectional study included 41 participants who had undergone TKA 6 months before the study due to osteoarthritis. Participants performed the TUG, 10MWT, SLST, 5xSST, and 2MWT. Each of the tests was performed twice, with a 1-day interval between tests. Intraclass correlation coefficient (ICC) models were used to determine the test–retest reliability. The level of correlations between performance tests and Berg Balance Scale and Fall Efficacy Scale-International were used to establish concurrent and convergent validity of the performance tests, respectively.ResultsThe mean age of the subjects was 64.07 ± 10.57 years. All tests showed excellent reliability (ICC > 0.94), excluding SLST that demonstrated good test–retest reliability (ICC = 0.72). All of the tests (SLST, 10MWT, 5xSST, 2MWT, TUG) were found to have good validity (rho > 0.704).ConclusionsAccording to these results, TUG, 10MWT, SLST, 5xSST, and 2MWT are reliable and valid outcome measures in patients with TKA, and could be used to assess balance after TKA surgery.

Fear of falling does not predict self-reported physical activity: an observational study with community-dwelling older adults

ObjectivesTo investigate the relationship between FOF and self-reported physical activity levels among older adults. DesignObservational cross-sectional. Setting and participantsCommunity-dwelling older adults aged 60 years and over and without cognitive deficits were recruited. Main outcome measuresData collected included cognitive function [i.e., Mini Mental Status Examination (MMSE)], FOF [i.e., Iconographic Falls Efficacy Scale (Icon-FES); Falls Efficacy Scale – International (FES-I)], self-reported physical activity (i.e., Modified Baecke Questionnaire for Elderly People), history of falls, number of comorbidities and clinical tests of balance and mobility (i.e., Short Physical Performance Battery and the single leg stance test with closed and opened eyes). Multivariable linear regression was used to test whether FOF predicts self-reported physical activity levels. ResultsA total of 200 older adults living in the community were enrolled in this study. Our results showed that FOF, as measured by FES-I or Icon-FES, did not predict self-reported physical activity levels in community-dwelling older adults. ConclusionOur results did not support previous evidence that higher FOF predicts lower levels of self-reported physical activity. These results question the role of FOF in influencing self-reported physical activity levels among community-dwelling older adults.

Old before their time: Comparisons of people with SMI and healthy older adults.

Compare physical functional measures of people with severe mental illness (SMI) to standardized geriatric values. Retrospective analysis of physical functioning sample data of middle-aged people with SMI was compared to standardized older adult data. Compared: Sit to Stand Test (STS; n = 68), 6 min Walk Test (6MWT; n = 71), and Single Legged Stance Test (SLS; n = 55). One sample t tests were computed, using standardized values for older adult healthy populations, to identify differences for the group. STS (M = 11.3 SD = 5.36), for the sample were comparable to 80-89 year old. The 6MWT values were significantly worse than 80-89-year-old range for women, t(28) = -2.88, p < .01, and men, t(40) = -5.32, p =. 00. SLS values for women and men were comparable to the 70-79-year-old range in the general population. People with SMI have functional fitness levels that are older than chronological age, and should be assessed regularly for physical functioning to support independent living. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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.

축구선수들의 포지션에 따른 균형 능력 비교 분석

The purpose of this study was to comparison of balance ability in male soccer athletes according to the position. In this study, the subject were 31 male high school soccer athletes. The displacement of center of pressure (CoP), standard deviation of CoP, velocity of CoP and trace length of CoP of both feet was evaluated with wireless foot pressure device (Moticon, Germany). And also, one single leg stance was measured. As a result of the study, This study was significantly lower the defender and midfielders than the forwards at the standard deviation of CoP in the non-dominant foot (p<.01). But, there was no statistically significant difference to the position; CoP of anterior-posterior (AP) in the both feet, CoP of medial-lateral (ML) in the both feet, deviation of CoP in the dominant foot, velocity of CoP in the both feet, trace length of CoP of both feet, (p>.05). In conclusion, this study was suggested that the men soccer players were showed differences in standard deviation of CoP of non-dominant foot according to the position.

The effect of cryotherapy on postural stabilization assessed by standardized horizontal perturbations of a movable platform

BackgroundCryotherapy is a frequently used therapy in the acute treatment of sports injuries, although it has possible negative effects on dynamic postural stabilization. Research questionWhat is the effect of cryotherapy on the postural stabilization assessed by imposed platform perturbations? MethodsTwenty-four healthy participants (15 male, 9 female) performed 2 test sessions (before and after cryotherapy) consisting of 4 trials each. Each trial included 30 s single leg stance (SLS) on both legs and 4 testing blocks (2 for each leg) of 30 s for the dynamic testing. A single testing block comprised 4 perturbations. After the first session, cryotherapy was applied to the right leg by placing it in ice water at a temperature between 10 °C and 12 ° for 20 min. Outcome measuresWe assessed the Center of Pressure speed (CoPs) and the mean force variation for both static and dynamic tests. Additionally, the Time To Stability (TTS) was calculated for the perturbations. ResultsIn the static trials there was an interaction between leg and session present for the mean force variation (p = 0.01) with a large η2 of 0.24, which shows higher variation of vertical force after application of the cryotherapy on the right leg. During the dynamic trials we found an interaction between leg and session for the TTS suggesting increase of the TTS due to the cryotherapy (p = 0.04), with a large η2 of 0.17. No interaction effect was present for the CoPs in the mediolateral and anteroposterior direction (p = 0.62 and p = 0.12, respectively). SignificanceCryotherapy applied to the lower extremity results in a worse postural stabilization when assessed by platform perturbations. This might be the result of an altered balance strategy, due to impaired proprioception from the affected body part. More research is needed to examine the duration of this effect. Level of evidenceLevel 3, associative study