Sex-Specific Dependence of Linear and Nonlinear Postural Control Metrics on Anthropometrics During Clinical Balance Tests in Healthy Young Adults

2020 ◽  
Vol 29 (4) ◽  
pp. 405-412
Author(s):  
Stephen M. Glass ◽  
Brian L. Cone ◽  
Christopher K. Rhea ◽  
Donna M. Duffy ◽  
Scott E. Ross
Keyword(s):  
Sexual Dimorphism ◽  
Postural Control ◽  
Center Of Pressure ◽  
Force Plate ◽  
Interactive Effects ◽  
Fluctuation Analysis ◽  
Scaling Exponent ◽  
Cross Sectional ◽  
Linear And Nonlinear ◽  
Positive Effect

Context: Previous work suggests that balance behavior is a sex-dependent, complex process that can be characterized by linear and nonlinear metrics. Although a certain degree of center of pressure variability may be expected based on sexual dimorphism, there is evidence to suggest that these effects are obscured by potential interactions between sex and anthropometric factors. To date, no study has accounted for such interactive effects using both linear and nonlinear measures. Objective: This investigation sought to analyze interactive models featuring sex, height, and weight as predictors of linear and nonlinear aspects of postural control. Design: Cross-sectional study. Setting: Controlled laboratory. Participants: A total of 26 males (23.80 [3.44] y, 177.87 [6.44] cm, 81.70 [10.80] kg) and 28 females (21.14 [2.03] y, 169.57 [8.80] cm, 64.48 [8.86] kg) were sampled from a healthy university population. Main Outcome Measures: Linear (range [RNG], velocity [VEL], and SD) and nonlinear (detrended fluctuation analysis scaling exponent, multivariate multiscale sample entropy [MMSECI]) summary metrics of center of pressure time series. Procedure: Participants stood on a force plate for 20 seconds in 3 conditions: double (D), single (S), and tandem (T) stance. Data for each stance condition were analyzed using regression models with interaction terms for sex × height and sex × weight. In D, weight had a positive, significant main effect on VELy, MMSECId, and MMSECIv. In men, height was observed to have a positive effect on SDy (S), RNGy (S), and RNGx (T) and a negative effect on MMSECIv (T). In women, weight was observed to have a positive effect on SDy and VELx (both T). Conclusions: Our findings suggest that men and women differ with respect to certain linear and nonlinear aspects of balance behavior, and that these differences may reflect sex-specific behavioral patterns in addition to effects related to sexual dimorphism.

scholarly journals Use of Virtual Reality to Assess Dynamic Posturography and Sensory Organization: Instrument Validation Study (Preprint)

2020 ◽  
Author(s):  
Matthew William Wittstein ◽  
Anthony Crider ◽  
Samantha Mastrocola ◽  
Mariana Guerena Gonzalez
Keyword(s):  
Virtual Reality ◽  
Center Of Pressure ◽  
Force Plate ◽  
Fluctuation Analysis ◽  
Scaling Exponent ◽  
Sensory Organization Test ◽  
Dynamic Posturography ◽  
Sensory Organization ◽  
Intraclass Correlations ◽  
Absolute Agreement

BACKGROUND The Equitest system (Neurocom) is a computerized dynamic posturography device used by health care providers and clinical researchers to safely test an individual’s postural control. While the Equitest system has evaluative and rehabilitative value, it may be limited owing to its cost, lack of portability, and reliance on only sagittal plane movements. Virtual reality (VR) provides an opportunity to reduce these limitations by providing more mobile and cost-effective tools while also observing a wider array of postural characteristics. OBJECTIVE This study aimed to test the plausibility of using VR as a feasible alternative to the Equitest system for conducting a sensory organization test. METHODS A convenience sample of 20 college-aged healthy individuals participated in the study. Participants completed the sensory organization test using the Equitest system as well as using a VR environment while standing atop a force plate (Bertec Inc). The Equitest system measures the equilibrium index. During VR trials, the estimated equilibrium index, 95% ellipse area, path length, and anterior-posterior detrended fluctuation analysis scaling exponent alpha were calculated from center of pressure data. Pearson correlation coefficients were used to assess the relationship between the equilibrium index and center of pressure–derived balance measures. Intraclass correlations for absolute agreement and consistency were calculated to compare the equilibrium index and estimated equilibrium index. RESULTS Intraclass correlations demonstrated moderate consistency and absolute agreement (0.5 < intraclass correlation coefficient < 0.75) between the equilibrium index and estimated equilibrium index from the Equitest and VR sensory organization test (SOT), respectively, in four of six tested conditions. Additionally, weak to moderate correlations between force plate measurements and the equilibrium index were noted in several of the conditions. CONCLUSIONS This research demonstrated the plausibility of using VR as an alternative method to conduct the SOT. Ongoing development and testing of virtual environments are necessary before employing the technology as a replacement to current clinical tests.

Does instructing attentional focus direction affect static single leg balance performance?

2021 ◽  
pp. 174795412110585
Author(s):  
Cory J Monahan ◽  
Wendy L Hurley
Keyword(s):  
Postural Control ◽  
Motor Skills ◽  
Center Of Pressure ◽  
Attentional Focus ◽  
Fluctuation Analysis ◽  
Scaling Exponent ◽  
Balance Performance ◽  
External Focus ◽  
Balance Task ◽  
And Control

Balance and postural control exercises are generally included as a part of exercise programs, during which movement practitioners can provide instructions to facilitate the performance of motor skills. Instructions can be used as cues to direct attentional focus, which has been found to affect the performance of motor skills, including balance and postural control tasks. However, no known studies to date have investigated the effect of both internal and external attentional focus instructions on static single leg balance performance, and it seems unclear whether effects of such instructions are related specifically to the direction of attention. The purpose of this study was to investigate the effect of instructing the direction of attentional focus on single leg static balance performance as reflected by the complexity of the center of pressure (COP) profile. Participants (N = 46) between the ages of 19–28 years old were randomly assigned to one of three group conditions: internal focus (INTn=15), external focus (EXTn=16) and control (CONn=15). Participants performed a thirty-five second static single leg balance task. Outcome measures were the scaling exponent determined from a detrended fluctuation analysis (DFA) to infer complexity of the COP profile in the anterior-posterior (AP) and medial-lateral (ML) directions, and root mean square error (RMSE) of the COP profile in AP and ML directions. A one-way analysis of variance (ANOVA) determined there were no statistically significant differences in the measured variables among groups. The results do not support the claim that manipulating the direction of attentional focus affects static single leg balance performance.

scholarly journals Use of Virtual Reality to Assess Dynamic Posturography and Sensory Organization: Instrument Validation Study

10.2196/19580 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e19580
Author(s):  
Matthew William Wittstein ◽  
Anthony Crider ◽  
Samantha Mastrocola ◽  
Mariana Guerena Gonzalez
Keyword(s):  
Virtual Reality ◽  
Center Of Pressure ◽  
Force Plate ◽  
Fluctuation Analysis ◽  
Scaling Exponent ◽  
Sensory Organization Test ◽  
Dynamic Posturography ◽  
Sensory Organization ◽  
Intraclass Correlations ◽  
Absolute Agreement

Background The Equitest system (Neurocom) is a computerized dynamic posturography device used by health care providers and clinical researchers to safely test an individual’s postural control. While the Equitest system has evaluative and rehabilitative value, it may be limited owing to its cost, lack of portability, and reliance on only sagittal plane movements. Virtual reality (VR) provides an opportunity to reduce these limitations by providing more mobile and cost-effective tools while also observing a wider array of postural characteristics. Objective This study aimed to test the plausibility of using VR as a feasible alternative to the Equitest system for conducting a sensory organization test. Methods A convenience sample of 20 college-aged healthy individuals participated in the study. Participants completed the sensory organization test using the Equitest system as well as using a VR environment while standing atop a force plate (Bertec Inc). The Equitest system measures the equilibrium index. During VR trials, the estimated equilibrium index, 95% ellipse area, path length, and anterior-posterior detrended fluctuation analysis scaling exponent alpha were calculated from center of pressure data. Pearson correlation coefficients were used to assess the relationship between the equilibrium index and center of pressure–derived balance measures. Intraclass correlations for absolute agreement and consistency were calculated to compare the equilibrium index and estimated equilibrium index. Results Intraclass correlations demonstrated moderate consistency and absolute agreement (0.5 < intraclass correlation coefficient < 0.75) between the equilibrium index and estimated equilibrium index from the Equitest and VR sensory organization test (SOT), respectively, in four of six tested conditions. Additionally, weak to moderate correlations between force plate measurements and the equilibrium index were noted in several of the conditions. Conclusions This research demonstrated the plausibility of using VR as an alternative method to conduct the SOT. Ongoing development and testing of virtual environments are necessary before employing the technology as a replacement to current clinical tests.

scholarly journals Habitual Physical Activity as a Determinant of the Effect of Moderate Physical Exercise on Postural Control in Older Men

2012 ◽  
Vol 7 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Rafał Stemplewski ◽  
Janusz Maciaszek ◽  
Maciej Tomczak ◽  
Robert Szeklicki ◽  
Dorota Sadowska ◽  
...  
Keyword(s):  
Physical Activity ◽  
Postural Control ◽  
Sagittal Plane ◽  
Center Of Pressure ◽  
Force Plate ◽  
Frontal Plane ◽  
Habitual Physical Activity ◽  
Similar Reaction ◽  
Mean Velocity ◽  
Ergometer Exercise

The aim of the study was to compare the effect of exercise on postural control (PC) among the elderly with lower or higher level of habitual physical activity (HPA). The study involved 17 elderly men (mean age 72.9 ± 4.79 years). Mean velocity of the center of pressure (COP) displacements was measured using a force plate both before and after cycle ergometer exercise. A significantly higher increase in mean velocity of COP displacements and its component in the sagittal plane were observed in the group with lower level of HPA in comparison with the group with higher HPA level. Simultaneously, a relatively similar reaction to the exercise in the frontal plane was observed in both groups, possibly connected to the specific type of used exercise, which mainly activated the sagittal muscles.

scholarly journals Is Postural Control Different in Boys and Girls? Comparison Between Sex

2020 ◽  
Vol 27 (4) ◽  
pp. 385-391
Author(s):  
Jessica Caroliny de Jesus Neves ◽  
Aryane Karoline Vital Souza ◽  
Dirce Shizuko Fujisawa
Keyword(s):  
Physical Activity ◽  
Postural Control ◽  
Test Performance ◽  
Center Of Pressure ◽  
Cross Sectional Study ◽  
Lateral Velocity ◽  
Cross Sectional ◽  
Stage Of Development ◽  
Significant Difference ◽  
Pressure Area

ABSTRACT The purpose of this study was to compare the postural control between eight-year-old boys and girls, considering the nutritional classification and level of physical activity. This was a cross-sectional study, with a sample of 346 participants, classified by the WHO AnthroPlus software, evaluated on the force platform and the Questionnaire Physical Activity for Children. The results demonstrated that girls showed lower values in relation to the opposite sex (p<0.001), in the center of pressure area (COP) (girls: 11.88 vs boys: 15.86cm2), Antero-posterior Amplitude (girl: 5.40 vs boy: 6.05cm), Medial-lateral Amplitude (girl: 3.97 vs boy: 4.40cm), Antero-posterior velocity (girl: 3.98 vs boy: 4.94cm/s), Medial-lateral velocity (girl: 3.98 vs boy: 4.59cm/s), Antero-posterior frequency (girl: 0.70 vs boy: 0.84Hz). Physical activity was associated with male sex (p=0.001; X2=11.195; odds ratio=0.372). In relation to the center of pressure of sedentary children, girls showed better postural control (p<0.001), but when we analyzed the center of pressure of both sexes who were active there was no statistically significant difference (p=0.112). The Z score of both sexes presented no difference in the center of pressure area (p=0.809 and p=0.785 respectively). Girls showed better postural control, while boys are more active; when both sexes performed physical activity COP area was similar. Therefore, special care should be taken when assessing postural control in boys and girls due to their differences in test performance and stage of development. As for interventions, exercise should be considered for better performance of the COP.

scholarly journals The Effects of Active Self-Correction on Postural Control in Girls with Adolescent Idiopathic Scoliosis: The Role of an Additional Mental Task

2020 ◽  
Vol 17 (5) ◽  
pp. 1640 ◽  
Author(s):  
Elżbieta Piątek ◽  
Michał Kuczyński ◽  
Bożena Ostrowska
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Postural Control ◽  
Repeated Measures ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Force Plate ◽  
Stroop Test ◽  
Quiet Standing ◽  
Mental Task

Due to balance deficits that accompany adolescent idiopathic scoliosis (AIS), the potential interaction between activities of daily living and active self-correction movements (ASC) on postural control deserves particular attention. Our purpose was to assess the effects of ASC movements with or without a secondary mental task on postural control in twenty-five girls with AIS. It is a quasi-experimental within-subject design with repeated measures ANOVA. They were measured in four 20-s quiet standing trials on a force plate: no task, ASC, Stroop test, and both. Based on the center-of-pressure (COP) recordings, the COP parameters were computed. The ASC alone had no effect on any of the postural sway measures. Stroop test alone decreased COP speed and increased COP entropy. Performing the ASC movements and Stroop test together increased the COP speed and decreased COP entropy as compared to the baseline data. In conclusion, our results indicate that AIS did not interfere with postural control. The effects of the Stroop test accounted for good capacity of subjects with AIS to take advantage of distracting attentional resources from the posture. However, performing both tasks together exhibited some deficits in postural control, which may suggest the need for therapeutic consultation while engaging in more demanding activities.

scholarly journals Effects of light touch on balance in patients with stroke

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 259-263
Author(s):  
Tae-sung In ◽  
Jin-Hwa Jung ◽  
Sang-hun Jang ◽  
Kyung-hun Kim ◽  
Kyoung-sim Jung ◽  
...  
Keyword(s):  
Postural Sway ◽  
Center Of Pressure ◽  
Force Plate ◽  
Cross Sectional Study ◽  
Support Surface ◽  
Light Touch ◽  
Mean Velocity ◽  
Cross Sectional ◽  
Surface Conditions ◽  
Hemiparetic Stroke

AbstractLight touch is the combination of cutaneous and kinesthetic inputs. The literature suggests that light touch compensates for a reduced amount of center of pressure information in older peoples, blind subjects and patients with neurological disorder. This study investigated the effects of light touch applied to an external bar, on the postural sway in individuals with hemiparetic stroke. We used a cross sectional study, fifteen individuals with stroke and 15 healthy age-matched adults stood as still as possible on a force plate. Experimental trials (duration, 30 s) included two visual conditions (open eyes and closed eyes), two somatosensory conditions (no touch and light touch) and two support surface conditions (firm and foam surfaces). The area of center of pressure (COP) and the mean velocity of COP in the medio-lateral and anterior-posterior directions were assessed. For both groups, COP velocity and area decreased with light touch regardless of the visual or surface conditions. The effects of light touch were similar in both groups. In addition, results show that the effectiveness of light touch in reducing postural sway was greater on a foam surface than on a firm surface. Our findings indicate that light touch could be beneficial in postural control for individuals with hemi-paretic stroke

Influence of Foot Type and Orthotics on Static and Dynamic Postural Control

2004 ◽  
Vol 13 (1) ◽  
pp. 54-66 ◽  
Author(s):  
Lauren C. Olmsted ◽  
Jay Hertel
Keyword(s):  
Postural Control ◽  
Athletic Training ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Center Of Pressure ◽  
Group Interaction ◽  
Force Plate ◽  
Balance Test ◽  
Repeated Measures Design ◽  
Plate Dynamic

Context:The effects of custom-molded foot orthotics on neuromuscular processes are not clearly understood.Objective:To examine these effects on postural control in subjects with different foot types.Design:Between-groups, repeated-measures design.Setting:Athletic training laboratory.Subjects:30 healthy subjects assigned to groups by foot type: planus (n = 11), rectus (n = 12), or cavus (n = 7).Interventions:Custom-fit semirigid orthotics.Main Outcome Measures:Static postural control was measured on a force plate. Dynamic postural control was measured using the Star Excursion Balance Test. Both measurements were assessed with and without orthotics at baseline and 2 weeks later.Results:For static postural control, a significant condition-by-group interaction was found. Subjects with cavus feet had a decreased center-of-pressure velocity while wearing orthotics. For dynamic postural control, a significant condition-by-direction-by-group interaction was found. Subjects with cavus feet had increased reach distances in 3 of 8 directions while wearing orthotics.Conclusions:Custom orthotics were associated with some improvements in static and dynamic postural control in subjects with cavus feet.

The Effect of Trial Duration on Single-Limb Stance Postural Control Measures

2014 ◽  
Vol 19 (4) ◽  
pp. 32-37 ◽  
Author(s):  
Cameron Powden ◽  
Matthew Hoch
Keyword(s):  
Postural Control ◽  
Outcome Measures ◽  
Force Plate ◽  
Healthy Adults ◽  
Control Measures ◽  
Practice Trial ◽  
Trial Duration ◽  
Cross Sectional ◽  
Eyes Open ◽  
Main Effects

Context:Currently, there are limited guidelines for the trial duration of quiet single-limb postural control tests. However, trial duration may influence the results of postural control assessments.Objective:To examine the effect of trial duration on instrumented measures of postural control in healthy adults.Design:Cross-sectional.Setting:Laboratory.Patients or Other Participants:Ten healthy adults (eight females, two males; age = 22.1 ± 1.5 years; 167.4 ± 9.3 cm; 67.4 ± 12.3 kg).Interventions:Static postural control was assessed using quiet single-limb stance on a force plate. With eyes open and closed, participants stood barefoot on one limb. Instructions were stand with hands on hips and remain as motionless as possible. A practice trial was performed before the collection of three 10 s trials on each limb for each visual condition. The data collected during each trial were analyzed as the initial 2.5 s, the initial 5 s, and 10 s.Main outcome Measures:The independent variables included vision, limb, and trial duration. The dependent variables included postural control examined using time-to-boundary (TTB) variables: mean of TTB minima (TTB-M) and the standard deviation of TTB minima (TTB-SD) in the anterior-posterior (AP) and medial-lateral (ML) directions.Results:No significant 3-way or 2-way interactions or limb main effects were identified. Main effects were identified for vision and trial duration in all TTB variables. Post hoc analysis revealed significant differences between all trial durations in all TTB variables.conclusions:Greater TTB values were exhibited during the 10 s trial durations compared with 5 s and 2.5 s, and 5 s trial durations compared with 2.5 s, indicating postural control improved with longer trial durations. This suggests differing aspects of postural control may be examined with different trial durations.

scholarly journals Postural control among elderly women with and without osteoporosis: is there a difference?

2010 ◽  
Vol 128 (4) ◽  
pp. 219-224 ◽  
Author(s):  
Thomaz Nogueira Burke ◽  
Fabio Jorge Renovato França ◽  
Sarah Rúbia Ferreira de Meneses ◽  
Viviam Inhasz Cardoso ◽  
Rosa Maria Rodrigues Pereira ◽  
...  
Keyword(s):  
Postural Control ◽  
Elderly Women ◽  
Center Of Pressure ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Clinical Test ◽  
Mineral Density ◽  
Maximum Displacement ◽  
Cross Sectional ◽  
School Of Medicine

CONTEXT AND OBJECTIVE: Little is known about postural control among elderly individuals with osteoporosis and its relationship with falls. It has been suggested that elderly women with kyphosis and osteoporosis are at greater risk of falling. The aim of this study was to evaluate posture and postural control among elderly women with and without osteoporosis. DESIGN AND SETTING: Cross-sectional study conducted at the Physical Therapy and Electromyography Laboratory, School of Medicine, Universidade de São Paulo (USP). METHODS: Sixty-six elderly women were selected from the bone metabolism disorders clinic, Division of Rheumatology, USP, and were divided into two groups: osteoporosis and controls, according to their bone mineral density (BMD). Postural control was assessed using the Limits of Stability (LOS) test and the Modified Clinical Test of Sensory Interaction and Balance (CTSIBm) and posture, using photometry. RESULTS: The elderly women with osteoporosis swayed at higher velocity on a stable surface with opened eyes (0.30 versus 0.20 degrees/second; P = 0.038). In both groups, the center of pressure (COP) was at 30% in the LOS, but with different placements: 156° in the osteoporosis group and 178° in the controls (P = 0.045). Osteoporosis patients fell more than controls did (1.0 versus 0.0; P = 0.036). CONCLUSIONS: The postural control in elderly women with osteoporosis differed from that of the controls, with higher sway velocity and maximum displacement of COP. Despite postural abnormalities such as hyperkyphosis and forward head, the COP position was posteriorized.

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