Single-leg Stance Research Articles

The Association between Multidirectional Speed Performance, Dynamic Balance and Chronological Age in Young Soccer Players.

The ability to maintain a stable single-leg balance stance during a fast change of direction movement is a fundamental aspect both for improving sport-specific skills and for prevention strategies. The aim of this cross-sectional study was to investigate the associations between multidirectional speed performance (MDS), dynamic balance performance (DBP), and chronological age in young and uninjured soccer players. In addition, it was examined whether chronological age and balance can predict variance in speed performance. One-hundred forty-six young male soccer players (age range 11–19) performed the y-balance test (YBT) and the lower extremity functional test (LEFT). Descriptive statistics, Pearson correlation, and multiple regression analysis were executed. The analyses were carried out on the further variables: for the DBP, the YBT composite score % (CS dominant leg/CS non-dominant leg) and limb symmetry index % (LSI) were used; for the MDS, the LEFT time in seconds (s) was used. Findings revealed LEFT scores to have a significant association with chronological age (p = 0.000), CS dominant (p = 0.019) and LSI (p = 0.044) of the YBT. In addition, CS dominant and chronological age explained the variance of the LEFT by 44%, regardless of LSI. To conclude, MDS revealed a strong association with DBP of the dominant side but a small association with LSI. In addition, a small association was found between quick LEFT times and older players. Finally, MDS variance can be predicted from DBP of the dominant side and chronological age in young soccer players. The tests used in this study could be useful screening tools for the detection of performance deficits, the implementation of prevention training programs, and the optimization of selection strategies in soccer academies.

Perturbation-based trunk stabilization training in elite rowers: A pilot study.

Low back pain is a major health issue in elite rowers. High training volume, frequent flexion movements of the lower spine and rotational movement in sweep rowing contribute to increased spinal strain and neuropathological patterns. Perturbation-based trunk stabilization training (PTT) may be effective to treat neuromuscular deficits and low back pain. All boat classes (8+, 4+/-, 2-) of the male German national sweep rowing team participated in this non-randomized parallel group study. We included 26 athletes (PTT: n = 12, control group: n = 14) in our analysis. Physical and Sports therapists conducted 16 individualized PTT sessions á 30-40 minutes in 10 weeks, while the control group kept the usual routines. We collected data before and after intervention on back pain intensity and disability, maximum isometric trunk extension and flexion, jump height and postural sway of single-leg stance. We found less disability (5.3 points, 95% CI [0.4, 10.1], g = 0.42) for PTT compared to control. Pain intensity decreased similar in both groups (-14.4 and -15.4 points), yielding an inconclusive between-group effect (95% CI [-16.3, 14.3]). Postural sway, strength and jump height tend to have no between- and within-group effects. Perturbation-based trunk stabilization training is possibly effective to improve the physical function of the lower back in elite rowers.

Pelvic elevation induces vertical kinetic energy without losing horizontal energy during running single-leg jump for distance

ABSTRACT In a running single-leg jump (RSLJ) for distance, the generation of vertical velocity without loss of horizontal velocity during the take-off phase is ideal, but difficult; however, we hypothesized that the pelvic rotation in the frontal plane achieved it. Here we show the effect of each segment rotation on the horizontal and vertical kinetic energies ( and ) of the centre of mass (CoM) during the take-off phase of an RSLJ for distance. We collected kinematic and ground-reaction-force data during RSLJs for distance by nine male long jumpers, involving an approximately 20-m approach in an outdoor field. We determined the components of the and changes due to each segment movement. Elevation of the pelvic free-leg side increased (0.53±0.16 J/kg, 9±3% of the total change). Pelvic axial rotation decreased , while pelvic elevation did not affect it (0.01±0.02 J/kg, no significant difference from zero). In contrast, forward rotations of the stance-leg shank and thigh decreased while simultaneously increasing . The results showed that pelvic elevation increased the vertical CoM velocity without causing a loss in horizontal velocity, although the lower-limb segments’ effects on the vertical and horizontal velocities exhibited a trade-off, as previously speculated. RSLJs for distance have been frequently assumed as sagittal movements. However, our findings highlight the importance of three-dimensional pelvic movement, particularly in the frontal plane, for controlling both the vertical and horizontal velocities. Highlights l We show the effect of each segment rotation on the horizontal and vertical kinetic energies ( and ) of the centre of mass during the take-off phase of a running single-leg jump for distance. l Elevation of the pelvic free-leg side increased but did not decrease , while the forward rotations of the stance-leg thigh and shank decreased , while simultaneously increasing . l We highlight the importance of pelvic movement in the frontal plane for controlling both the vertical and horizontal velocities with single-leg stance.

Motor signature of autism spectrum disorder in adults without intellectual impairment

Motor signs such as dyspraxia and abnormal gait are characteristic features of autism spectrum disorder (ASD). However, motor behavior in adults with ASD has scarcely been quantitatively characterized. In this pilot study, we aim to quantitatively examine motor signature of adults with ASD without intellectual impairment using marker-less visual-perceptive motion capture. 82 individuals (37 ASD and 45 healthy controls, HC) with an IQ > 85 and aged 18 to 65 years performed nine movement tasks and were filmed by a 3D-infrared camera. Anatomical models were quantified via custom-made software and resulting kinematic parameters were compared between individuals with ASD and HCs. Furthermore, the association between specific motor behaviour and severity of autistic symptoms (Autism Diagnostic Observation Schedule 2, Autism Spectrum Quotient) was explored. Adults with ASD showed a greater mediolateral deviation while walking, greater sway during normal, tandem and single leg stance, a reduced walking speed and cadence, a greater arrhythmicity during jumping jack tasks and an impaired manual dexterity during finger tapping tasks (p < 0.05 and |D|> 0.48) compared to HC. Furthermore, in the ASD group, some of these parameters correlated moderately to severity of ASD symptoms. Adults with ASD seem to display a specific motor signature in this disorder affecting movement timing and aspects of balance. The data appear to reinforce knowledge about motor signs reported in children and adolescents with ASD. Also, quantitative motor assessment via visual-perceptive computing may be a feasible instrument to detect subtle motor signs in ASD and perhaps suitable in the diagnosis of ASD in the future.

Factors Associated With Abnormal Joint Contact Pressure After Periacetabular Osteotomy: A Finite-Element Analysis

BackgroundIdentifying factors associated with poor hip contact mechanics after periacetabular osteotomy (PAO) may help surgeons optimize acetabular corrections in individual patients. We performed individual-specific finite-element analyses to identify preoperative morphological and surgical correction factors for abnormal contact pressure (CP) after PAO. MethodsWe performed finite-element analyses before and after PAO with reference to the standing pelvic position on individual-specific 3-dimensional hip models created from computed tomography images of 51 dysplastic hips. Nonlinear contact analyses were performed to calculate the joint CP of the acetabular cartilage during a single-leg stance. ResultsThe maximum CP decreased in 50 hips (98.0%) after PAO compared to preoperative values, and the resulting maximum CP was within the normal range (<4.1 MPa) in 33 hips (64.7%). Multivariate analysis identified the roundness index of the femoral head (P = .002), postoperative anterior center-edge angle (CEA; P = .004), and surgical correction of lateral CEA (Δlateral CEA; P = .003) as independent predictors for abnormal CP after PAO. A preoperative roundness index >54.3°, a postoperative anterior CEA <36.3°, and a Δlateral CEA >27.0° in the standing pelvic position predicted abnormal CP after PAO. ConclusionPAO normalized joint CP in 64.7% of the patients but was less likely to normalize joint CP in patients with aspheric femoral heads. Successful surgical treatment depends on obtaining adequate anterior coverage and avoiding excessive lateral correction, while considering the physiological pelvic tilt in a weight-bearing position.

MO607: Intradialytic Exercise: A Large-Scale Nationwide Implementation Study

Abstract BACKGROUND AND AIMS Intradialytic exercise (IDE) is recommended for HD patients. However, this recommendation is mostly based on research conducted under optimal instead of real-world conditions, limiting generalizability and its implementation into routine clinical care. This study aims to analyze implementation outcomes of IDE in real-world conditions at a large-scale, nationwide level. METHOD After a pilot experience in a single unit, all NephroCare Portugal dialysis clinics were invited to initiate an IDE program. A national coordinator was nominated, and a nurse and a doctor were selected in each unit as local coordinators. A simple exercise protocol was designed to be easily applied by current dialysis staff (though some units benefited from exercise science student internships). The IDE protocol includes a bout of aerobic exercise (cycle ergometer) and lower limb resistance exercises (ankle weights). The RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework was used to study clinical implementation over the first year. For each RE-AIM dimension, specific implementation outcomes were adapted to IDE. Effectiveness measures included safety (incidence of intradialytic adverse events over 1 year) and physical function at baseline and at 1 year (sit to stand 30, 8-foot up &amp; go, handgrip strength, sit to stand 5 and single leg stance). For safety measures, IDE group was compared to a group of patients that refused IDE. Physical function measures were only applied to IDE patients, and so comparisons were made between low- and high-frequency exercise groups. RESULTS Adoption: 21 dialysis units (58.3%). Reach: 1270 eligible patients (55.8%). Main reasons for noneligibility were physical/cognitive incapacity (50.8%) and cardiovascular risk (34.9%). Eligible patients were younger (P &amp;lt; 0.001) and had a better health status (lower comorbidity index: P &amp;lt; 0.001; lower prevalence of diabetes: P &amp;lt; 0.001; lower fat tissue index: P &amp;lt; 0.001; and a higher lean tissue index: P &amp;lt; 0.001). 811 (63.9%) committed to the intervention. Compared with non-IDE patients, IDE patients were younger (&amp;lt;0.001), had a lower dialysis vintage (&amp;lt;0.001), a lower comorbidity index (P &amp;lt; 0.001) and a higher lean tissue index (P = 0.035). Implementation: adherence to exercise sessions was 75.0% ± 19.7%. In 77% of the 50 356 HD treatments, exercise was performed as prescribed. Non-performed exercise sessions (n = 9768) are mostly justified by patient refusal (61.5%) and pain (8.4%). Patients performed 2.2 ± 0.6 exercise sessions/week achieving 86.3 ± 29.0 min/week. Maintenance (setting level): none of the clinics interrupted IDE. Maintenance (patient level): attrition rate was 57.2% mainly due to voluntary withdrawal (52.4%). Comparing to voluntary withdrawals, completers were mainly males (P &amp;lt; 0.001) and had a lower dialysis vintage (P = 0.007), and higher lean tissue index (P = 0.023). Effectiveness: IDE (n = 347) and non-IDE patients (n = 394) were compared. Total incidence of adverse events was lower in IDE, but no significant differences were found (P = 0.808). The individual analysis of each adverse event demonstrated no significant differences for cramps, hypotension, needle dislodgement and other adverse events. Overall physical function improved in IDE (P &amp;lt; 0.001), despite a slight reduction in handgrip strength (P = 0.001). A within-group (low- versus high-frequency exercise) effect was observed, highlighting a deterioration in handgrip strength in the low-frequency group (P = 0.002), whereas no change was observed in the high-frequency group (P = 0.097). CONCLUSION Large-scale implementation of IDE is a realistic and safe way to promote physical activity in HD patients with benefits on physical function. Yet, to optimize its generalizability, strategies to increase patients´ acceptability and long-term adherence are needed.

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.