Single-leg Stance Research Articles

Improvement of cervical spine mobility and stance stability by wearing a custom-made mandibular splint in male recreational athletes.

The range of motion (ROM) of the cervical spine and postural stability are important for an economical and motorically adequate adaptation of the body to any situation. Therefore, this study aims to analyze whether these two components of postural and movement control can be influenced by means of a splint in a centric position compared to habitual occlusion. 38 recreational male athletes volunteered. Cervical spine ROM was recorded using an ultrasound system and the a pressure measuring plate for postural stability (length of center of pressure (CoP) movement, area of CoP). The two dental occlusion conditions employed were the habitual occlusion and wearing a splint in an idealized, condylar position close to the centric position. Level of significance was set at ρ ≤ 0.05. The cervical spine mobility increased significantly by wearing the splint regarding rotation to the left (+3.9%) and right (+2.7%) and lateral flexion to the left (+4.4%) and right (+6.7%). Wearing the splint reduced the area of sway deflections by about 31.5% in the bipedal stance and by about 2.4% (left) and 28.2% (right) in the unipedal stance. The CoP trace was reduced in the sagittal plane by approximately 8.2% in the right single-leg stance. The major findings seem to demonstrate that wearing a splint that keeps the jaw close to the centric relation may increase the cervical ROM and may improve balance stability in male recreational athletes. Changing the jaw relation in athletes can possibly aid the release of performance potentials by improving coordination skills.

Contribution of Hip Abductors Muscles on Bone Mineral Density and Functionality in Older Women

Background: Despite the well-established role of muscle in maintaining bone mass and physical performance, there are still few studies that assess the relationship between muscle groups and specific bone sites and its contribution to physical function in older people. The aim of the study is to verify the association between hip and knee's muscle strength and bone mineral density of the femoral neck (BMD-FN) and investigated which muscle strength that are related with BMD-FN is associated with physical function in older women. Methodology: This is a cross-sectional study of 94 women over the age of 60 years, physically independent. Muscle strength of the hip and knee was evaluated using an isokinetic dynamometer (Biodex, USA) to obtain peak torque (PT). The BMD-FN was obtained using dual-energy x-ray absorption densitometry (DXA). Physical function was evaluated by the Timed Up and Go (TUG), gait speed (GS), five times stand to sit (5TSS) and single-leg stance (SS). To verify the association between muscle strength (independent variable) and the BMD-FN (dependent variable) and the relationship between muscle strength (independent variable) and clinical tests (dependent variable), the multiple linear regression was carried out, adjusted for age, time of menopause, height and level of physical activity. All of the analyses were carried out by the SPSS 17.0 software, with a level of p < 0.05 significance. Results: We found an association between the hip abductors PT and the BMD-FN and between hip abductors PT and all clinical tests. Conclusion: We observe that hip abductor muscle strength contributes to BMD-FN and to performance in several clinical tests in older women. These findings reinforce the importance of this musculature not only for improving balance and gait, but also it can be a strategy to maintain/improve bone mass in the femoral neck in this population.

Relationship between physical activity level and plantar sensitivity, balance in postmenopausal women

This research was planned to investigate the relationship between physical activity level and plantar sensitivity, static and dynamic balance in postmenopausal women. Forty women between the ages of 50 and 65, who had not had a menstrual period for at least 12 months, and who had undergone menopause due to hormonal, surgical or natural means were involved in the research. International Physical Activity Questionnaires Short Form (IPAQ-SF) was used to assess the level of physical activity. Light touch pressure threshold on soles of the individuals and two-point discrimination sense were evaluated bilaterally from 6 different regions of the sole of the foot. Single leg and tandem stance tests were used for static balance assessment. Dynamic balance was evaluated with Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). As a result of the statistical analysis, a negative correlation was found between the total physical activity level of the participants and the light touch pressure of the right big toe. There was a significant negative correlation between total physical activity level and left big toe, and the 1st and 5th metatarsal heads of the left foot. A significant negative correlation between total physical activity level and TUG test was detected. However, no significant difference between total physical activity and BBS, static balance tests was found. As a result of this research, it was concluded that the level of physical activity affects the light touch sense of big toes of both feet, and the 1st and 5th metatarsal heads of left foot. During this study, it was seen that if total physical activity level decreases, then the score of TUG can increase. Physical activity level and related factors should be examined with a larger number of samples.

Superior Gait Symmetry and Postural Stability among Yoga Instructors-Inertial Measurement Unit-Based Evaluation.

This study investigates gait symmetry and single-leg stance balance of professional yoga instructors versus age-matched typically developed controls using inertial measurement unit (IMU)-based evaluation. We recruited twenty-five yoga instructors and twenty-five healthy control subjects to conduct the walking experiments and single-leg stance tests. Kinematic data were measured by attaching IMUs to the lower limbs and trunk. We assessed the asymmetry of swing phases during the normal-walk and tandem-walk tests with eyes open and closed, respectively. The subjects subsequently conducted four single-leg stance tests, including a single-leg stance on both legs with eyes open and closed. Two balance indexes regarding the angular velocities of the waist and chest were defined to assess postural stability. The gait asymmetry indexes of yoga instructors were significantly lower than those of the typically developed controls. Similarly, the yoga instructors had better body balance in all four single-leg stance tests. This study's findings suggest that yoga improves gait asymmetry and balance ability in healthy adults. In the future, further intervention studies could be conducted to confirm the effect of yoga training.

The effect of single and dual-task balance exercises on balance performance in older adult patients with degenerative lumbar spinal stenosis: A randomized controlled trial

BackgroundLumbar Spinal Stenosis (LSS) may present with balance disorder and risk of falling as a result of posture problems. The aim of the present study was to compare the effects of single-task and dual-task balance exercise programs on balance performance and activity-specific balance confidence in adults with LSS. MethodsForty-three patients with LSS over the age of 65 were randomly divided into 2 groups as single-task balance training (group 1, n=21) and double-task balance training (group 2, n=22). Patients in both groups were given exercises by an experienced physiotherapist. Only balance exercises were applied to Group 1 under single task conditions, and Group 2 performed balance exercises accompanied by predetermined cognitive tasks. Patients were evaluated with Berg balance scale (BBS), timed up and go (TUG) test, and 10-meter walking test for single and dual tasks, Tinetti balance and gait test, single leg stance test, and activities-specific balance confidence (ABC) scale at baseline and at the end of four weeks. The Mann-Whitney U Test was used to compare the pre- and post-treatment differences in the groups. ResultsDemographic data did not show any statistical significance between the two groups. When the pre- and post-treatment differences of the 10-meter walk test were compared between the single-task training group and the dual-task training group, it was observed that there was a difference in favor of the dual-task training group in the 10-meter walk test was performed separately in the single-task and dual-task training group (p < 0.05). When the differences before and after treatment were compared, no difference was observed in the BBS, TUG, Tinetti balance and gait test, single leg stance test, and ABC scale data between the groups (p > 0.05). ConclusionSingle- and dual-task exercises significantly improved static balance, dynamic balance, and activity-specific balance confidence in older adults with spinal stenosis. However, the dual-task exercise program was superior to the single-task exercise program in improving 10-meter walk test scores and walking speed, with or without cognitive dual-tasking.

Assessing the Association of Shoulder Pain Risk with Physical Fitness in Badminton Players at National Tournament Level

Background: Shoulder pain which affects sports performance and activities of daily life, is a common musculoskeletal problem experienced by badminton players. Objectives: This study aimed to identify the association of shoulder pain with physical fitness in elite university badminton players participating in the national tournament via medical check-ups. Methods: Physical fitness evaluations were performed among fifty-two 18 - 22 years old university badminton players participating in the national tournament. Handgrip strength, heel buttock distance, angle of straight leg raise, single leg stance, shoulder range of motion, and trunk range of motion were assessed. The prevalence of present shoulder pain was described. Multivariable logistic regression was used to examine the association of present shoulder pain with physical fitness. Results: Sixteen badminton players (30.8%) sustained present shoulder pain related to badminton. Dominant trunk rotation (adjusted OR: 0.91, 95% CI: 0.84 - 0.99, P-value = 0.028) and single leg stance of the nondominant leg (adjusted OR: 0.97, 95% CI: 0.94 - 1.00, P-value = 0.048) were significantly associated with the presence of present shoulder pain. Conclusions: Decreased trunk rotation and deficit in single-leg stance balance might be potential risk factors associated with physical fitness for shoulder pain in university badminton players at national tournament level. These findings can help draw the attention of badminton coaches, players, and team members to facilitate physical fitness promotion for badminton pain/injury prevention.

Assessment of Dynamic Balancing Performance of Synchronized Ice Skaters With Sudden Provocation Test via Principal Component Analysis

Background: Balancing performance can be affected by regular and high-level athletic training, which has not been fully explored in synchronized ice skaters. This study aimed to analyze the dynamic balancing performance by assessing the principal and compensatory movements performed during the sudden provocation tests and evaluating the parameters that characterize the platform’s motion. Method: Twelve young female synchronized ice skaters and 12 female age-matched controls participated. Sudden provocation tests were completed three times in bipedal stance and in single-leg stances, and sport-specific fatigue session was inserted between the repetitions. Results: Significantly more time was necessary to recover balance for both groups after the fatiguing sessions (p &lt; .05). Interestingly, skaters performed less effectively in the simplest condition (bipedal stance) than the control group (p &lt; .05). The principal component analysis showed that the first principal movement was the same for both groups. The skater group used the upper body and arms more often to compensate, while the control group’s recovery strategy consisted mainly of abduction of the elevated leg. The damping ratio and the relative variance of the first principal movement showed a negative correlation (p &lt; .05), suggesting that those with superior balancing effectiveness recruited more compensatory movements.

Young Pediatric Buffalo Concussion Exam Identified Physiological Dysfunction in an Adolescent after Repetitive Concussions

<h3>Research Objectives</h3> To describe the utility of a brief pediatric physical exam, the Young Pediatric Buffalo Concussion Physical Exam (YPBCPE), in an adolescent after hockey-related concussions. <h3>Design</h3> Case Report. <h3>Setting</h3> Academically-affiliated research laboratory. <h3>Participants</h3> A 16–year old male with a history of two concussions sustained within the past 12 months while playing hockey at the school/travel level was examined 10-weeks post-injury. One 15-minute, in-person visit was completed. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> The Post-Concussion Symptom Scale (PCSS) was used to examine the perceived severity (0 being no symptoms and 6 being the highest severity) of concussion-related symptoms. The YPBCPE was used to identify the presence of persistent post-concussive signs and symptoms (PPCS). <h3>Results</h3> The patient reported no (0) balance symptoms and mild (2) visual problems on the PCSS. On the YPBCPE, the patient experienced lightheadedness when standing up from a supine position during the 2-minute supine to 1-minute stand test. Optic nerve exam revealed a reduction in visual fields. Dizziness and sustained nystagmus were observed when horizontal smooth pursuits were tested. Testing near point convergence revealed a prolonged break and recovery at 9 cm and 16 cm, respectively. The patient maintained his balance for < 10 seconds during the single-leg (eyes closed) stance. <h3>Conclusions</h3> While self-report questionnaires provide meaningful information regarding symptoms, field-expedient physical exams help to more objectively establish ongoing physiological dysfunction in youth with PPCS, which may guide treatment. Resolution of abnormal findings also assists in more reliably clearing youth to return to activities. Currently, no markers exist to quantify PPCS in children. The YPBCPE could be valuable in identifying therapies to aid youth with PPCS who report few symptoms on self-report measures. <h3>Author(s) Disclosures</h3> The authors declare no conflict of interest.

Postural Sway Differences in Individuals with Unilateral Plantar Fasciitis Versus Healthy Controls

<h3>Research Objectives</h3> To examine postural sway in the involved versus the uninvolved limb in those with unilateral plantar fasciitis (PF), as well as to compare postural sway with gender-matched healthy participants. <h3>Design</h3> A case-control comparative study. <h3>Setting</h3> University research laboratory. <h3>Participants</h3> Twenty participants with unilateral PF (mean age 47 years, 13 females) were compared between involved and uninvolved feet as well as with twenty gender-matched healthy controls (mean age 43 years, 13 females). Observers were blinded to which was the involved foot in the PF group. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Center of pressure (COP), 95% ellipse confidence area (CEA). <h3>Results</h3> When examining single leg stance performance with the involved feet of the PF group, a significantly higher COP (p=0.01, effect size η2=0.9) and CEA (p=0.05, η2=0.5) was observed in comparison to healthy controls. A similar difference was also observed when comparing COP (p=0.03, η2=0.6) and CEA (p=0.05, η2=0.1) in the uninvolved feet in the PF group with healthy controls. When comparing the single leg stance performance of the involved versus the uninvolved feet in the PF group, no difference was observed (COP, p=0.98; CEA, p=0.38). <h3>Conclusions</h3> Individuals with PF seem to exhibit increased postural sway when compared to gender-matched healthy individuals. This observation appears to be a global characteristic as either the involved or uninvolved foot in the PF group demonstrates this deficit. The presence of increased postural sway in both the involved and uninvolved feet versus healthy highlights the need to further study risk factors for PF to better treat and prevent the condition. In light of bilateral PF being a common occurrence, the specific relationship between increased postural sway and PF should be included in future studies. <h3>Author(s) Disclosures</h3> None.

Percutaneous screw fixation of the pubic symphysis versus plate osteosynthesis: a biomechanical study.

Objectives: To compare the stability of screw fixation with that of plate fixation for symphyseal injuries in a vertically unstable pelvic injury (AO/Tile 61-C1) associated with complete disruption of the sacroiliac joint and the pubic symphysis. Methods: Eight fourth-generation composite pelvis models with sacroiliac and pubic symphyseal disruption (Sawbones, Vashon Island, WA) underwent biomechanical testing simulating static single-leg stance. Four were fixed anteriorly with a symphyseal screw, and 4 with a symphyseal plate. All had single transsacral screw fixation posteriorly. Displacement and rotation were monitored at both sacroiliac joint and pubic symphysis. Results: There was no significant difference between the 2 groups for mean maximum force generated. There was no significant difference in net displacement at both sacroiliac joint and pubic symphysis. There was significantly less rotation but more displacement in the screw group in the Z-axis. The screw group showed increased stiffness compared with the plate group. Conclusions: This is the first biomechanical study to compare screw versus plate symphyseal fixation in a Tile C model. Our biomechanical model using anterior and posterior fixation demonstrates that symphyseal screws may be a viable alternative to classically described symphyseal plating.

Clinician-administered performance-based tests via telehealth in people with chronic lower limb musculoskeletal disorders: Test–retest reliability and agreement with in-person assessment

Introduction Uptake of telehealth has surged, yet no previous studies have evaluated the clinimetric properties of clinician-administered performance-based tests of function, strength, and balance via telehealth in people with chronic lower limb musculoskeletal pain. This study investigated the: (i) test–retest reliability of performance-based tests via telehealth, and (ii) agreement between scores obtained via telehealth and in-person. Methods Fifty-seven adults aged ≥45 years with chronic lower limb musculoskeletal pain underwent three testing sessions: one in-person and two via videoconferencing. Tests included 30-s chair stand, 5-m fast-paced walk, stair climb, timed up and go, step test, timed single-leg stance, and calf raises. Test–retest reliability and agreement were assessed via intraclass correlation coefficients (ICC; lower limit of 95% confidence interval (CI) ≥0.70 considered acceptable). ICCs were interpreted as poor (<0.5), moderate (0.5–0.75), good (0.75–0.9), or excellent (>0.9). Results Test–retest reliability was good-excellent with acceptable lower CI for stair climb test, timed up and go, right leg timed single-leg stance, and calf raises (ICC = 0.84–0.91, 95% CI lower limit = 0.71–0.79). Agreement between telehealth and in-person was good-excellent with acceptable lower CI for 30-s chair stand, left leg single-leg stance, and calf raises (ICC = 0.82–0.91, 95% CI lower limit = 0.71–0.85). Discussion Stair climb, timed up and go, right leg timed single-leg stance, and calf raise tests have acceptable reliability for use via telehealth in research and clinical practice. If re-testing via a different mode (telehealth/in-person), clinicians and researchers should consider using the 30-s chair stand test, left leg timed single-leg stance, and calf raise tests.

Body asymmetries as risk factors for musculoskeletal injuries in dancesport, hip-hop and ballet dancers?

The study aimed to determine the incidence and expression of body asymmetries in dancers of three different dance styles: dancesport (n = 14), hip-hop (n = 21) and ballet (n = 20) and to examine how body asymmetries (muscle strength and power, stability and range of motion) are associated with musculoskeletal injuries occurring over the past 12 months. Cross-sectional and retrospective study. Maximal isometric voluntary contraction was measured for trunk, hip, knee and ankle movements. Participants performed a single leg stance, unilateral landing, weight bearing symmetry, squat and countermovement jump on force platforms. Passive range of motion was measured for hip, knee and ankle with two-arm goniometer or digital inclinometer (hip flexion, extension and rotations). A retrospective questionnaire was used to collect data on musculoskeletal injuries occurring in the last 12 months. Different dance styles were associated with different body asymmetries, including strength asymmetries (hip flexion and external rotation), agonist/antagonist asymmetries (trunk flexion/extension, hip abduction/adduction, ankle dorsi/plantar flexion) and hip adduction and internal rotation range of motion asymmetries. Moreover, strength asymmetries of hip flexion, adduction and abduction/adduction as well as stability asymmetries were associated with the total number of musculoskeletal injuries. The incidence of body asymmetries (> 10%) in dancesport, hip-hop and ballet dancers was confirmed, as well as the association of some asymmetries with self-reported injuries occurring over the last 12 months. The cause-effect relationship should be clarified by further studies.

The best position of bone grafts in the medial open-wedge high tibial osteotomy: A finite element analysis

Background and objectiveThe application of wedge-shaped bone grafts can increase the biomechanical stability of knee during the medial open-wedge high tibial osteotomy (MOWHTO) by reducing the von Mises stress of the medial plate and lateral cortical hinge area. However, the optimal position of bone grafts it remains unclear, so we aimed to determine search for the optimal position of the bone grafts in MOWHTO by using finite element analysis. MethodsIn the finite element analysis, MOWHTO models were established with three different osteotomy distraction heights and assembled into four groups according to different conditions, including the no bone grafts (NBG) group, the anterior bone grafts (ABG) group, the middle bone grafts (MBG) group, and the posterior bone grafts (PBG) group. Based on previous studies, 600 N and 1800 N loads were applied to the knee joint to simulate the static forces during a double and single leg stance to measure the von Mises stress of the medial implant area and lateral hinge area, the maximum displacement of different models, the relative displacement of the osteotomy area and the stress distribution in the bone grafts. ResultsCompared to the NBG and ABG groups, the stress of the lateral cortical hinge area and the medial implate area was significantly lower in the PBG group. For example, under the 600N force load, when the height of the osteotomy area was 10 mm, 15 mm, and 20 mm, the maximum von Mises stress of the medial implate area and lateral cortical hinge area in the NBG group were 140, 141, 172, and 53, 57, 60 MPa, respectively. Compared with the NBG group, the maximum von Mises stress of the medial implate area and lateral cortical hinge area in the PBG group were reduced by 45%, 56%, 63% and 14%, 39%, 68% at distraction height of 10 mm, 15 mm, and 20 mm, respectively. The bone grafts in the posterior parts provide the best stability,with the stress of the middle and posterior bone grafts are mainly concentrated in the edge. ConclusionsThe posterior part of the osteotomy area is the best position for bone graft placement since it provides optimal stability and reduces von Mises stress in the medial plate and lateral cortex hinge area, with the stress of the posterior bone grafts mainly concentrated in the edge. These findings guide bone graft placement sites in clinical surgery and are a basis for future research on bone graft materials and structures in MOWHTO.

Impact of Joint Fixation on Postural Dynamics during Single-Leg Stance

We investigated the relationship between the mechanical degrees of freedom (DoF) and its postural dynamics. The joint DoF was fixed to constrain the mechanical DoF. Nine participants were required to perform a single-leg stance task. The center of pressure trajectory data was analyzed. Ankle fixation induced a larger amount of variability in the anteroposterior direction, and less dimensionality and complexity in the mediolateral direction. These results suggest that the ankle joint fixation caused limited postural sway in the mediolateral direction; therefore, functional DoF and complexity decreased. In contrast, it increased the amount of postural sway variability in the anteroposterior direction. Our findings imply a direct relationship between the mechanical DoF of the human movement system and its postural dynamics.

Evaluation of the Functional Status of the Posture Control System in Children with Detected Disorders in Body Posture.

Screening tests for body posture defects and abnormalities conducted over the past several decades have revealed a significant and constantly increasing problem of health risks in children. A sedentary lifestyle, which is considered to be the primary cause, can result in proprioceptive disorders leading to postural instability. The aim of the study was to find the correlation between the level of proprioceptive control and the number of postural disorders. The study involved a representative group of 1090 children aged 8-10 years, from randomly selected primary schools. Subjects who scored from 1 to 5 points in a prior postural screening test were qualified for the examination of the postural control system. The examination of the postural control system was carried out using an electronic station enabling assessment of postural stability and proprioception. A single leg stance test showed that the number of postural disorders does not significantly impact proprioceptive control. Proprioceptive control was found to significantly increase with the age of the children, and girls presented significantly better proprioceptive control in relation to the boys in each age group.

Comparing efficacy of a single intraarticular injection of platelet-rich plasma (PRP) combined with different hyaluronans for knee osteoarthritis: a randomized-controlled clinical trial

BackgroundIntraarticular plasma-rich platelet (PRP) and hyaluronic acid (HA) have each been shown to be effective for treating knee osteoarthritis (OA). Evidence supporting the combination therapy is controversial. This study aimed to investigate the efficacy of a single intraarticular PRP injection combined with different HAs in patients with knee OA.MethodsIn this prospective randomized-controlled trial, 99 patients with Kellgren-Lawrence grade 2 knee OA with average knee pain ≥ 30 mm on a 0-100 mm pain visual analog scale (VAS) were randomized into two groups. The PRP + Artz group received a single intraarticular HA (Artz, 2.5 ml, 10 mg/ml) followed by 3 ml PRP (n = 50). The PRP + HYAJOINT Plus group received a single intraarticular cross-linked HA (HYAJOINT Plus, 3 ml, 20 mg/ml) followed by 3 ml PRP (n = 49). All patients were evaluated before and at 1, 3 and 6 months after injections. The primary outcome was the VAS pain reduction from baseline at 6 months. Secondary outcome measures included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne index, single leg stance (SLS) test and patient satisfaction.ResultsNinety-five patients were analyzed by intention-to-treat analysis. Both groups improved significantly in VAS pain, WOMAC, Lequesne index and SLS at 1, 3 and 6 months post intervention (p < 0.05). Between-group comparisons showed no significant differences at most follow-up time points, except better improvements in Lequesne index at 1 month (p = 0.003) and WOMAC-stiffness score at 6 months (p = 0.020) in the PRP + Artz group, and superiority in SLS at 1, 3 and 6 months in the PRP+ HYAJOINT Plus group (p < 0.001, p = 0.003 and p = 0.004). Additional Johnson-Neyman analyses showed that among the patients with baseline WOMAC-pain score > 8.5, WOMAC-function score > 21.7 and WOMAC-total score > 32.0, respectively, those treated with PRP + HYAJOINT Plus injections had better effects in WOMAC-pain, WOMAC-function and WOMAC-total scores than those treated with PRP + Artz at 3 months postinjection (p < 0.05). Both groups reported high satisfaction. No serious adverse events occurred during the study.ConclusionsA single PRP injection combined with Artz or HYAJOINT Plus is effective and safe for 6 months in patients with knee OA. Both injection regimens are potential treatment options for knee OA. Further studies are needed to confirm these results.Trial registrationThe study was registered at ClinicalTrials.gov (NCT04931719), retrospectively. Date of registration 18/6/2021.Name of trial registryComparing efficacy of single PRP combined with different hyaluronans for knee osteoarthritis.Level of evidenceTherapeutic Level 1.

Relation Analysis of Range of Motion and Motor Ability in Adult with Cerebral Palsy

Studies so far have not clarified the relationship with ROM by directly measuring the motor ability in adult with cerebral palsy, even though ROM is closely related to motor ability. Therefore, the purpose of this study is to reveal the relationship between AROM and motor ability based on the close relationship between ROM and motor ability of cerebral palsy.BR The subjects of this study were 101 adults with cerebral palsy (63 men and 38 women, 36.4±8.9 years old in average age, 162.8±9.6 cm in average height, 59.6±11.2 kg in weight, and 22.5±3.7 kg･m-2 in BMI) using three cerebral palsy welfare centers in Korea.BR The ROM measurement was performed by measuring the AROM (Active Range of Motion), and the items were 25 parts of 7 regions of the whole body. In addition, the motor ability measurements were a total of 10 items of motor ability (grip strength, shoulder strength, sit-up, left-back, and softball throwing) which mainly uses the upper extremities, and 5 items of motor ability (50 m running, side steps, single leg stance, standing long jump and 10 m shuttle run test).BR As a result of analyzing the correlation between AROM and motor ability, significant correlation with all exercise abilities was recognized in the ablation and under burst of foot joints in AROM (p.05). In particular, in the relationship between the bowing of the foot joint and standing long jump, the highest value of all correlation coefficients was shown (p.01). On the other hand, extra-shoulder joint rotation was not recognized to be correlated with all motor skills. In addition, there was less motor ability that showed a significant correlation with neck joint flexion and elongation, intra-shoulder joint rotation, and wrist joint extension. Most of the AROMs of the upper extremity were recognized to have a significant correlation with grip strength, shoulder muscle strength, and trunk forward flexion (p.05). In addition, most of the AROMs in the lower extremities were significantly correlated with sit-ups, convulsions, softball throwing, 50m running, side steps, single leg stance, long jump, and shuttle run test (p.05).BR Taken together, the development of foot and hip AROM among lower limb joints is considered the most important to obtain high motor skills in ambulatory cerebral palsy.

Changes in dual-task cognitive performance elicited by physical exertion vary with motor task.

Integrated movement and cognitive load paradigms are used to expose impairments associated with concussion and musculoskeletal injury. There is currently little information on the discriminatory nature of dual-task complexity and the relative influence of physical exertion on cognitive outcomes. Assess cognitive performance while under motor conditions of increasing complexity before and after a standardized exercise protocol. 34 participants were recruited (17 male and 17 female; 24 ± 1.4 yrs). A modified Eriksen flanker test was used to assess cognitive performance under four conditions (seated, single-leg stance, walking, and lateral stepping) before and after a 20-min moderate-to vigorous intensity treadmill protocol. The flanker test consisted of 20 sets of 5-arrow configurations, appearing in random order. To complete the response to cognitive stimulus, participants held a smartphone horizontally and were instructed to respond as quickly and as accurately as possible by tilting the device in the direction corresponding to the orientation of the middle arrow. The metrics used for analysis included average reaction time (ms), inverse efficiency index (average reaction time penalized for incorrect responses), and conflict effect (the average time cost of responding to an incongruent repetition vs. a congruent repetition). Mixed effects (condition by time) RMANOVAs were conducted to examine the effects of motor task complexity and physical exertion on cognitive performance. There was a condition by time interaction for inverse efficiency index (p < 0.001), in which participants displayed higher cognitive efficiency for the pre-activity lateral stepping condition compared to the other three conditions (Cohen's d = 1.3-1.6). For reaction time and conflict effect, there were main effects for condition (p = 0.004 and 0.006, respectively), in which performance during lateral stepping was improved in relation to the seated condition (reaction time Cohen's d = 0.68; conflict effect Cohen's d = 0.64). Participants tended to display better dual-task cognitive performance under more stimulating or complex motor tasks before physical exertion, likely associated with the inverted-U arousal-performance relationship. When using dual-task assessments, clinicians should be mindful of the accompanying motor task and baseline exertion levels and their potential to disrupt or optimize cognitive performance.

Relationships among postural stability, physical fitness, and shooting accuracy in Olympic female goalball players.

This study aims to examine the relationship between postural perfor-mance, physical fitness level, and shooting performance in Olympic fe-male goalball players. Eight Olympic-level goalball players (age: 20.63± 4.37 years) were recruited from the Turkish National Women's Goalball Team. Postural stability, physical fitness, and shooting performance of the players were measured. The postural stability was determined us-ing body sway measurements during parallel and single-leg stances on a force plate. The physical fitness level of the players is evaluated by curl-up, isometric push-up, trunk lift, and grip strength (dominant hand) tests. A goalball-specific shooting accuracy test was used for shooting performance. Independent sample t-test and Pearson correlation were used for statistical processing. No statistical difference was observed in body sway parameters between open eyes and closed eyes condi-tions except for the anteroposterior sway area. Some of the body sway parameters performed under different stances positively correlated with all physical fitness tests (P<0.05). There was a positive correlation between the shooting accuracy and trunk lift score (r=0.767). Right leg sway area anterior-posterior and ellipse area negatively correlated with shooting accuracy (r=-0.629 and r=-0.692 respectively). It is necessary to attach importance to the improvement of the physical fitness level specific to core strength to maintain postural stability for visually im-paired athletes. In our study, some factors affecting shooting accuracy were identified, but it is necessary not to restrict a complex structure such as shooting accuracy within certain concepts.

Geometry and bone mineral density determinants of femoral neck strength changes following exercise

Physical exercise induces spatially heterogeneous adaptation in bone. However, it remains unclear where the changes in BMD and geometry have the greatest impact on femoral neck strength. The aim of this study was to determine the principal BMD-and-geometry changes induced by exercise that have the greatest effect on femoral neck strength. Pre- and post-exercise 3D-DXA images of the proximal femur were collected of male participants from the LIFTMOR-M exercise intervention trial. Meshes with element-by-element correspondence were generated by morphing a template mesh to each bone to calculate changes in BMD and geometry. Finite element (FE) models predicted femoral neck strength changes under single-leg stance and sideways fall load. Partial least squares regression (PLSR) models were developed with BMD-only, geometry-only, and BMD-and-geometry changes to determine the principal modes that explained the greatest variation in neck strength changes. The PLSR models explained over 90% of the strength variation with 3 PLS components using BMD-only (R2 > 0.92, RMSE < 0.06 N) and 8 PLS components with geometry-only (R2 > 0.93, RMSE < 0.06 N). Changes in the superior neck and distal cortex were most important during single-leg stance while the superior neck, medial head, and lateral trochanter were most important during a sideways fall. Local changes in femoral neck and head geometry could differentiate the exercise groups from the control group. Exercise interventions may target BMD changes in the superior neck, inferior neck, and greater trochanter for improved femoral neck strength in single-leg stance and sideways fall.